Outcome Analysis of 9-Gauge MRI-Guided Vacuum-Assisted Core Needle Breast Biopsies

Rauch, Gaiane M.; Dogan, Basak E.; Smith, T; Liu, Ping; Yang, Wei Tse

doi:10.2214/ajr.11.7594

Cited by 78 publications

(67 citation statements)

References 35 publications

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“…The malignancy rate in our cohort of women with MRI-visible breast lesions who underwent MRI-guided biopsy or MRI-guided localization prior to surgery was 10.7% (8% at MRI-guided core biopsy and 20% of MRI-guided needle localization with surgical biopsy), which is lower than the reported range of 18 to 60% 3–11 and lower than the ACR BI-RADS® Atlas 2013 benchmark of 20–50%, 12 suggesting over-biopsying of lesions at our institution. Analyzing the characteristics of biopsied lesions with benign pathologies may help us identify lesions which may forego biopsies in the future.…”

Section: Discussioncontrasting

confidence: 57%

“…4, 9, 11, 23–25 Although at our institution we routinely obtain an average of 6 core biopsy samples, some institutions report obtaining as many as 12 samples. 3 As our upgrade rate is within the reported range, this suggest that the lesions were adequately sampled with an average of 6 samples, although statistical analysis of our upgrade rate as it relates to the number of the samples obtained was underpowered for definitive statistical analysis.…”

Section: Discussionmentioning

confidence: 99%

“…3–11 The variation is probably related to differences in patient populations, study designs and radiologist thresholds for recommending biopsy. Per the American College of Radiology BI-RADS Atlas 2013, the benchmark for the malignancy rate of MRI-guided biopsies performed (also known as the biopsy yield of malignancy or positive predictive value 3 (PPV 3 )) is 20–50%.…”

Section: Introductionmentioning

confidence: 99%

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MRI-Guided Breast Biopsy: Outcomes and Effect on Patient Management

Myers

Kamel

Macura

2015

Clinical Breast Cancer

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Introduction The purpose of this study was to correlate the pathology results of magnetic resonance imaging (MRI)-guided breast biopsies at our institution to MRI findings and patient clinical history characteristics. The impact of MRI-guided breast biopsies on surgical management in patients with a new diagnosis of breast cancer was also assessed. Patients and Methods In this HIPAA-compliant study we retrospectively reviewed all MRI-guided breast biopsies performed 3/2006–5/2012. Clinical history, MRI features and pathology outcomes were reviewed. In patients undergoing breast MRI to evaluate extent of disease, any change in surgical management resulting from the MRI-guided biopsy was recorded. Statistical analysis included binary logistic regression and independent student’s t-test. Results Two-hundred fifteen lesions in 168 patients were included, of which 23 (10.7%) were malignant, 43 (20%) were high risk, and 149 (69.3%) were benign. No clinical characteristic was associated with malignancy in our cohort. MRI features associated with malignancy were: larger size (mean 2.6 cm versus 1.3 cm, p=0.046), washout kinetics (18% malignancy rate, p=0.02) and marked background parenchymal enhancement (40% malignancy rate, p-value <0.001 to 0.03). Nineteen (28%) of the 67 patients with a new diagnosis of breast cancer undergoing MRI-guided breast biopsy had a change in surgical management based on the biopsy result. Conclusions Malignancy rate was associated with lesion size, washout kinetics and marked background enhancement of the breast parenchyma but was not associated with any clinical history characteristics. Pre-operative MRI-guided breast biopsies changed surgical management in 28% of women with a new diagnosis of breast cancer.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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MRI-Guided Breast Biopsy: Outcomes and Effect on Patient Management

Myers

Kamel

Macura

2015

Clinical Breast Cancer

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“…MRI-guided biopsy has no corresponding evaluation method such as specimen imaging in stereotactic biopsy or real-time monitoring in ultrasound-guided biopsy; therefore, radiologic-pathologic concordance requires caution. The positive predictive value of a lesion detected by MRI with subsequent MRI-guided biopsy is 16-61%; a radiologist should be aware that for radiologic-pathologic correlation, the positive predictive value is affected by the prevalence of breast cancer in a patient population (19,30,33,36,(38)(39)(40). A six-month follow-up is recommended for a benign concordant biopsy result (41).…”

Section: Radiologic-pathologic Correlationmentioning

confidence: 99%

“…A six-month follow-up is recommended for a benign concordant biopsy result (41). The rate of radiology-pathology discordance is not high (0% to 10.7%); but the mean proportion of malignancies in discordant cases is 37.5%, and surgical excision is recommended for discordant lesions (Table 3) (19,29,30,34,36,38,39).…”

Section: Radiologic-pathologic Correlationmentioning

confidence: 99%

Breast Magnetic Resonance Imaging-Guided Biopsy

Yun

Kim

Jang

et al. 2016

J Korean Soc Radiol

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Despite the high sensitivity of breast magnetic resonance imaging (MRI), pathologic confirmation by biopsy is essential because of limited specificity. MRI-guided biopsy is required in patients with lesions only seen on MRI. We review preprocedural considerations and the technique of MRI-guided biopsy, challenging situations and troubleshooting, and correlation of radiologic and pathologic findings.

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Clinical Value of Shear Wave Elastography Added to Targeted Ultrasound (Second‐Look Ultrasound) in the Evaluation of Breast Lesions Suspicious of Malignancy Detected on Magnetic Resonance Imaging

Ghai

et al. 2019

J of Ultrasound Medicine

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Objectives-To determine the value of shear wave elastography (SWE) added to targeted ultrasound (US) after breast magnetic resonance imaging (MRI).Methods-From July 2015 to October 2017, 40 patients who underwent targeted US evaluations of suspicious MRI-detected American College of Radiology Breast Imaging Reporting and Data System category 4 lesions (mass or nonmass enhancement) were enrolled in this prospective study. B-mode US and SWE examinations were performed to detect US correlates to MRI-detected lesions; their Breast Imaging Reporting and Data System categories were recorded; lesions that were dark blue on a 6-point color scale or had maximum elasticity of 30 kPa or less were categorized as soft. Biopsy was performed with US or MRI guidance, with the pathologic findings correlated with MRI, US, and SWE findings. The value of SWE for lesion detection and identification of benign lesions was determined.Results-The mean age of the 40 patients was 51.1 years. There were 48 MRIdetected lesions (20 cancers, 3 high-risk lesions, and 25 benign lesions). Ultrasound correlates (8 category 3 and 25 category 4) were shown for 33 lesions (69%; P < .0001), with 16 cancers (80%; P < .0001) and 17 benign lesions. Shear wave elastography assisted detection of 3 (19%) cancers on US imaging. All 7 soft US category 3 lesions were benign (7 of 33 [21%]; P = .0014).Conclusions-Shear wave elastography was useful with targeted US after breast MRI to increase cancer detection by US. A significant number of US correlates to MRI-detected lesions could have been identified as benign (category 3 and soft) before biopsy, with the potential of short-interval follow-up of MRIdetected lesions with benign US correlates instead of biopsy.

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Outcome Analysis of 9-Gauge MRI-Guided Vacuum-Assisted Core Needle Breast Biopsies

Cited by 78 publications

References 35 publications

MRI-Guided Breast Biopsy: Outcomes and Effect on Patient Management

MRI-Guided Breast Biopsy: Outcomes and Effect on Patient Management

Breast Magnetic Resonance Imaging-Guided Biopsy

Clinical Value of Shear Wave Elastography Added to Targeted Ultrasound (Second‐Look Ultrasound) in the Evaluation of Breast Lesions Suspicious of Malignancy Detected on Magnetic Resonance Imaging

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