Breast biopsies to determine if a woman has breast cancer can be extremely traumatic — both physically and mentally. Now, thanks to a new device at the University of Nebraska Medical Center, women facing breast biopsies have a new option that provides several benefits over the traditional biopsy procedure.
The device — called Advanced Breast Biopsy Instrumentation (ABBI) — is the first such system in a Nebraska hospital. It provides a digitally-enhanced computer image of the area to be biopsied, thus allowing the physician to take less breast tissue and be more accurate in locating the area to be biopsied.
For the patient, there are several advantages including reduced time in the operating room, a local anesthesic instead of a heavy sedation, a smaller incision, less tissue removed, less trauma to the breast, and a faster recuperation time.
“The ABBI procedure is a major advancement in the treatment of breast disease,” said James Edney, M.D., associate professor in UNMC’s surgery department and chief of surgical oncology. “It is a win-win situation for the patient as well as the physician. I believe it won’t be too long before this procedure becomes the standard for all breast biopsies performed for abnormal mammograms.”
Dr. Edney said an abnormal mammogram refers to any breast lesion that is not palpable to the physician’s touch.
The ABBI procedure is done on an outpatient basis. The patient lies face down on an elevated operating table with the breast extending down through an opening in the table.
ABBI can ascertain the exact location of the area to be biopsied within one millimeter, or about 1/20th of an inch, Dr. Edney said. After the lesion site is determined, a small incision of less than an inch is made and a small cylinder is inserted into the breast. A tiny circular blade inside the cylinder cuts out the breast tissue needed for the biopsy. The tissue remains inside the cylinder and can’t be seeded to other parts of the breast.
“Having done traditional breast biopsies for many years, I’m aware of the shortcomings of the standard procedure,” Dr. Edney said. “It can take up to four hours when you include localization of the lesion in the radiology suite to completion of the surgery in the operating room. Because of the limitations of the equipment, the targeting wire placed by mammography techniques may miss the intended lesion by up to an inch, and as a result, excessive normal breast tissue may have to be removed, resulting in a larger than necessary incision.
“With the ABBI procedure, it takes about 40 minutes. The patient is conscious the entire time and only receives a local anesthesic in the area of the breast incision. Because it is so accurate, only a minimal amount of breast tissue is taken.”
The ABBI is manufactured by United States Surgical Corporation in Norwalk, Conn. It costs $280,000. However, by trading out some old equipment, UNMC purchased the device at a net cost of about $120,000, Dr. Edney said. Over the past six weeks, Dr. Edney has used the ABBI for approximately 20 breast biopsies.
For more information on the ABBI procedure, contact Dr. Edney’s office at (402) 559-7272.