Women in Utah Valley have less to fear now from breast disease.
The Pink Ladies Auxiliary at Utah Valley Regional Medical Center has just paid $250,000 for an Advanced Breast Biopsy Instrumentation system, which can take a tissue sample under local anesthetic on an outpatient basis.The Advanced Breast Biopsy Instrumentation, or ABBI system, combines the best of the two most common biopsy procedures - needle localization with open surgical biopsy and core needle biopsy - and makes it available as a less intrusive outpatient option.
Needle localization is a two-step process that starts in radiology with insertion of a needle or wire marker in the breast. With the marker in place, the patient is moved to surgery where the tissue specimen is removed through an open incision.
With core needle biopsy, several passes are required to obtain enough tissue for a sufficiently large sample.
Many women who find a lump in a breast put off getting medical attention because they fear surgery, says Dr. Bruce McIff, medical director of imaging. Even a "simple" biopsy can be extremely stressful for a patient.
As many as 1 million women undergo breast biopsies every year, however.
The ABBI equipment makes it possible for a surgeon to remove tissue for biopsy without having to put a woman under general anesthetic or heavy sedation.
The patient lies on a table, where her breast is analyzed by a stereotactic X-ray machine, which can find a lesion to within 1 millimeter of accuracy. Once a middle-of-the-target area is defined by a needle probe relying on the X-ray information, a kind of disposable cutting gun with a rotating scalpel blade moves into the breast, taking a core sample of tissue that's about one-third smaller in size than the sample usually removed in surgery.
As a result, there is less recuperation time required and very little pain because there's less tissue removed. The patient can generally leave the hospital within one to two hours.
"This give us options," McIff said. "We can design what will give the best results for the individual patient."
Best of all, the system has the support of a variety of medical experts involved in the diagnosis and treatment of cancer - oncologists, surgeons, radiologists and care-givers.
"This takes the fear out of breast disease," he said.
McIff said the incision is only about 2 to 3 millimeters long and the "hole" left after the tissue sample is removed closes fairly quickly. Only a few stitches and a bandage are required following the procedure, and only minimal scarring occurs.
That helps in the future when doctors need to determine if another lump or lesion has developed, he said.
"It's good medicine when you can have a biopsy or small incision over having cancer," McIff said.
Although statistics show one out of 10 women in America will develop breast cancer in her lifetime, fewer are dying. McIff said the incident rate hasn't changed much. Women still need to take breast cancer very seriously and have a mammogram yearly - especially after 40.
"We just had a really sad story," he said. "We had a lady who had a mammogram faithfully every year until 1992. Then she missed from 1992 to 1994 until she came in with a mass we could have got to much earlier if she'd just kept up with the yearly screenings."
McIff says almost all insurance companies and even tightly managed health-care programs will pay for mammograms today.
Patients recommended for the Advanced Breast Biopsy Instrumentation system will be those who have enough breast tissue to give the machine tissue to read, those who can comfortably lie on the stereostatic X-ray table and those who have a mass not clearly readable by other methods.
Those with neck problems or severe arthritis may not be able to lie on the table long enough without pain, he said.
Five Utah Valley surgeons and one from American Fork Hospital have trained on the new equipment.
Currently, according to McIff, the ABBI at the Provo hospital is the only one operational in Utah right now. Other Intermountain Health Care hospitals are waiting to see how the pilot operation at Utah Valley Regional Medical Center goes, he says.
Also, McIff expects that it won't be long before the advanced biopsy procedure becomes a treatment option as well as a diagnostic option.
"There'd be no reason to go back in, no reason at all," he said.