[Stereotaxic excisional biopsy of non-palpable breast lesions by the ABBI(Advanced Breast Biopsy Instrumentation) technique. Advantages. Disadvantages. Indications. Apropos of 67 cases].

OBJECTIVES

Introduce briefly: the classification of the American College of Radiology for non palpable breast lesions; and the different techniques used for stereotactic breast biopsies. Evaluate the efficiency of the ABBI technique for non palpable breast lesions and its role in breast biopsies, on the base of 67 cases.

SUBJECTS AND METHOD

Sixty-seven stereotactic excisional biopsies on dedicated prone tables were performed using the ABBI technique for 21 probably benign and 46 indeterminate non palpable breast lesions seen on mammograms. Twenty-five cases were densities, architectural distortions or radial scars, and 42 were microcalcifications.

RESULTS

In our hands, the technique is 100% specific and sensitive. This high percentage of success is related to a team work between radiologists, surgeons or gynecologists. The specimen represent the whole lesion. Ductal carcinoma in situ (DCIS) and atypic ductal hyperplasia (ADH) are diagnosed with accuracy. Twelve carcinomas are found, three of them DCIS. ADH was encountered in two cases. Complications are minor, hematomas of small and moderate volume were encountered in eight cases (12%).

CONCLUSION

ABBI technique replaces surgical biopsies after wire hook localisation for solitary lesion smaller than two cm in diameter; and stereotactic Tru-cut biopsies, even with vacuum aspiration, for small cluster of microcalcifications, architectural distortion and radial scar, where the percentage of failure is higher. For malignant lesions, surgery must follow, even when the margins are free.