Usefulness of magnetic resonance imaging-guided vacuum-assisted breast biopsy in Korean women: a pilot study

Abstract

BackgroundMagnetic resonance imaging (MRI)-guided vacuum-assisted biopsy is the technique of choice for lesions that are visible only with breast MRI. The purpose of this study was to report our clinical experience with MRI-guided vacuum-assisted biopsy in Korean women.MethodsA total of 13 patients with 15 lesions for MRI-guided vacuum-assisted biopsy were prospectively entered into this study between September 2009 and November 2011. Biopsy samples were obtained in a 3-T magnet using a 9-guage MRI-compatible vacuum-assisted biopsy device. We evaluated clinical indications for biopsy, lesion characteristics on prebiopsy MRI, pathologic results, and postbiopsy complication status.ResultsThe clinical indications for MRI-guided vacuum-assisted biopsy were as follows: abnormalities in patients with interstitial mammoplasty on screening MRI (n = 10); preoperative evaluation of patients with a recently diagnosed cancer (n = 3); and suspicious recurrence on follow-up MRI after cancer surgery (n = 1) or chemotherapy (n = 1). All lesions have morphologic features suspicious or highly suggestive of malignancy by the American College of Radiology Breast Imaging Reporting and Data System category of MRI (C4a = 12, C4b = 2, C5 = 1). In two of the 15 lesions (13.3%, <6 mm), MRI-guided 9-gauge vacuum-assisted breast biopsy was deferred due to nonvisualization of the MRI findings that led to biopsy and the lesions were stable or disappeared on follow up so were considered benign. Of 13 biopsied lesions, pathology revealed four malignancies (4/13, 30.8%; mean size 15.5 mm) and nine benign lesions (9/13, 69.2%; size 14.2 mm). Immediate postprocedural hematoma (mean size 23.5 mm) was observed in eight out of 13 patients (61.5%) and was controlled conservatively.ConclusionsOur initial experience of MRI-guided vacuum-assisted biopsy showed a success rate of 86.7% and a cancer diagnosis rate of 30.8%, which was quite satisfactory. MRI-guided vacuum-assisted breast biopsy is a safe and effective tool for the workup of suspicious lesions seen on breast MRI alone without major complication. This biopsy may contribute to the early diagnosis of breast cancer in interstitial mammoplasty patients in Korea.

The Positive Outcome of MRI-Guided Vacuum Assisted Core Needle Breast Biopsies is not Influenced by a Prior Negative Targeted Second-Look Ultrasound

“…Our low rate of deferred biopsies could be related to technical improvements available with the utilised coil and computer-aided detection, allowing overcoming technical challenges that could have been encountered in initial studies. Interestingly, and contrary to Han et al [19] and An et al [24], who did not find any malignancy in the case of deferred biopsies (although a higher deferral rate of 13%), 1 case in our series corresponded to a DCIS. This situation is in keeping with the articles of Hefler et al [25] and Niell et al [26], who detected a 10% malignancy rate in similar situations.…”

MRI-Guided Breast Intervention: Biopsy and Needle Localization

“…이들은 유방 촬영술이나 초음파로는 유방암 검진이 매우 제한되기 때문에 유방암 검진으로써 자기공명영상을 권고하기도 한다. 만약 시행한 유방 자기공명영상에서 유방암 의심 소견이 발견된다면, 이들은 초음파 유도하 생검이나 입체정위생검술이 불가능하기 때문에 자기공명영상 유도하 조직생검술이 유일한 진단 방법이 된다( 15 16 ).…”

Recent Progress for the Techniques of MRI-Guided Breast Interventions and their applications on Surgical Strategy

“…For the biopsy, the average time spent in the MRI is from 20 to 90 minutes, and this is increased by 30 to 50% when two sites are biopsied [65,[94][95][96]. Mitra Noroozian et al [41] reported that the duration of the procedure depends on the number of images and checks in the tunnel, whether or not an assistant is present and proximity to the nipple, and it is independent of patient age, size of the breast and type or size of enhancement.…”