The introduction of mammography with an accompanying interest for diagnosis and treatment in non-palpable breast lesions had led to the practice of non-resectional biopsy such as mammography guided core needle biopsy, US guided fine needle aspiration cytology and localization & excisional biopsy. The recent technique, ABBI system has made it possible to excise a lesion completely under local anesthesia, providing a more reliable and rapid evaluation without necessity of admission.

We have studied 126 patients who were in evaluation for non-palpable breast disease at Samsung Medical Center from Dec. 1996 to April 1998. Forty two patients received core needle biopsy, whereas 84 cases of them received excision by using the ABBI system. After cutting the lesion off, we took a postexcisional mammography and a specimen mammography in order to confirm the evidence of complete excision. Pathologists examined the permanent specimen and in the case of malignancy, total mastectomy or re-excision was performed to secure a pathologically negative resection margin.

We observed malignant lesions in 15 of 126 patients. And DCIS was found in 10 of the malignancies. Postoperative pathologic reports showed DCIS in 5 and infiltrating ductal carcinoma in 1 of the 6 malignancies proven by stereotactic core biopsy, Among the 9 malignancies proven by the ABBI system, there were DCIS in 5, LCIS in I, infiltrating ductal carcinoma in 1 and mucinous carcinoma in 2. Futhermore, needle localization was performed in cases where malignancies were suspected in mammography but not in the stereotactic biopsy, and 2 of the cases revealed DCIS.

ABBI system is a more reliable and rapid method to evaluate breast lesions compared with stereotactic core biopsy, and can be achieved under local anesthesia minimizing the deformity of the remnant breast. Therefore ABBI system can be used as a substitute for conventional localization & excisional biopsy.