Prone table large core biopsy - The ABBI system

Major drawbacks of breast screening are the high rate of surgical intervention in patients without breast cancer and the necessity for open diagnostic biopsy. We have prospectively assessed stereotactic excision and stereo core biopsies performed on a prone table for nonpalpable lesions (ABBI, USSC). The decision to perform a core biopsy or excision was based on radiological suspicion, type of radiological abnormality and stereo FNAC result. All procedures were done as day cases under local anaesthesia and a patient satisfaction questionnaire was completed. ABBI - Advanced Breast Biopsy Instrumentation, DCIS - Ductal carcinoma in-situ, FNAC - fine needle aspiration cytology. 108 successful stereolocalised procedures were performed in 110 consecutive patients. n = 108 Benign DCIS Invasive Equivocal Core Biopsy n=74 47(3-radial scar) 14 10 3 (DCIS) Excision n = 34 16 7 11 Nil Median biopsy weight 8g 7g 12g - Core biopsy underestimated the disease in 9 cases. ABBI excision was accurate histologically in all 34 cases and only 2 patients experienced more than slight discomfort. This study questions the accuracy of core biopsy and suggests that stereotactic excision may be a more appropriate diagnostic procedure in selected cases.