Julie Hatch chatted about fruit trees and watched as a doctor removed a tumor from her breast.
She arrived at Deaconess Medical Center just after 8 a.m. Friday and was home less than four hours later. She looked after a pool full of preteen boys that afternoon. And she returned to work in the records department at Deaconess on Monday.
“I really felt no pain,” said Hatch, 37. “To me, that’s awesome. To not have an IV, to not have general anesthesia, is great.”
Hatch was the 11th woman to have a breast biopsy at Deaconess with a new procedure called Advanced Breast Biopsy Instrumentation, or ABBI. Two of the women tested positive for breast cancer.
Two shadows showed up on Hatch’s first mammogram June 4. By the time she left the hospital Friday, she knew the first lesion wasn’t cancerous. She’s still deciding how the second will be handled.
Mammograms show tumors. Spots with solid, regular borders usually are benign. Those with spiderlike stars or more irregular borders often are cancerous. But only a biopsy of the tissue will determine if the mass is truly cancer.
As many as 1 million women undergo breast biopsies every year. One in nine women will develop breast cancer during her lifetime.
The ABBI machine, which cost about $250,000, can lessen the pain, disfigurement and scarring linked to the two most common breast biopsy techniques. The procedure can also be performed under local instead of general anesthesia, meaning the woman is awake the entire time.
It’s part of the trend toward performing operations and procedures through small incisions. In 1990, doctors started removing gall bladders through tiny slits in the stomach. Certain heart surgeries can now be performed through small incisions.
Minimally invasive surgery is usually less expensive than more traditional operations and allows patients to resume normal activities almost immediately.
This ABBI procedure is $1,200 to $1,500 cheaper than a traditional biopsy.
The machine is the only one in Spokane, and Dr. Steve Beyersdorf is the only local doctor now certified to use it. He and others learning the technique practiced on eggplants implanted with Tums tablets and raisins.
“We’re going to do this at Family-A-Fair pretty soon,” joked Beyersdorf, referring to Spokane’s annual family educational event as he examined Hatch’s breast Friday before starting the procedure.
Hatch lay face down on the thin blue table, her body resting on foam padding and her left breast dropping through a hole. The ABBI machine then compressed her breast, and a needle was pushed into a spot marked the day before.
An X-ray was taken, popping up on a computer screen, showing the guide needle just shy of the pea-sized tumor. The needle was then frozen in place, marking the spot.
“We’re going to numb you up a whole bunch more now,” Beyersdorf said.
After giving her more local anesthesia, Beyersdorf pushed a cannula - a narrow tube with a knife blade at the end - into her breast. The room was silent, except for the click of the blade moving back and forth, 15 millimeters past the lump.
“You doing OK?” Beyersdorf asked.
“I’m fine,” Hatch said.
“I’m doing OK,” the doctor said.
“That’s reassuring,” Hatch replied.
More X-rays were shot, showing the cannula had grabbed the tumor plus a rim of normal tissue, necessary for testing. Beyersdorf then heated up a wire on the end of the tube, which cut the end of the sample.
The tissue was removed and taken to a pathologist for testing. Another X-ray was taken. The procedure was over.
“I have to say it was extremely painless,” Hatch said.
“Good,” Beyersdorf replied. “It’s too late to put it back.”
This technique isn’t for everyone. Another breast biopsy method should be used for women with larger lumps, lesions close to the chest wall, or breasts smaller than A-cups.
But for some women, the biopsy can remove the entire tumor. If the tumor is cancerous, the surgeon can determine whether more surgery or chemotherapy is needed.
“It’s better for doctors, better for women,” Beyersdorf said. “The thing’s gone and you’re not on this medical treadmill.”
, DataTimes ILLUSTRATION: Color photo