MR-Guided vacuum biopsy of 206 contrast-enhancing breast lesions.
OBJECTIVE
To determine the accuracy and clinical use of MR-guided vacuum biopsy (VB) of enhancing breast lesions.


METHODS
254 lesions were referred to MR-guided vacuum-assisted breast biopsy. In 43 (16 %) patients the indication was dropped because the lesions could not be identified at the time VB was scheduled. This was due to hormonal influences (n = 37), to too strong compression (n = 3) or to misinterpretation of the initial diagnostic MRI (n = 3). In 5 cases (2 %) VB was not performed due to obesity (n = 2); problems of access (n = 2) or a defect of the MR-unit (n = 1). VB was performed on altogether 206 lesions. In 4 cases (2 %) VB was unsuccessful. This was immediately realized on the post-interventional images. Thus a false negative diagnosis was avoided. Verification included excision of the cavity in cases with proven malignancy or atypical ductal hyperplasia (ADH) and (for benign lesions) retrospective correlation of VB-histology with pre-and postinterventional MRI and subsequent follow-up.


RESULTS
51/202 successful biopsies proved malignancy. In 7 cases ADH and in 144 cases a benign lesion was diagnosed. One DCIS was underestimated as ADH. All other benign or malignant diagnoses proved to be correct.


CONCLUSIONS
MR-guided VB allows reliable histological work-up of contrast-enhancing small lesions which are not visible by any other modality.
Perlet
C
C
Institut für Klinische Radiologie, Klinikum der Universität Grosshadern, München, Germany.
Schneider
P
P
Amaya
B
B
Grosse
A
A
Sittek
H
H
Reiser
M F
MF
Heywang-Köbrunner
S H
SH
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000295:instrumentation*; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005348:Fibrocystic Breast Disease / Q000473:pathology; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D006965:Hyperplasia; D007089:Image Enhancement; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008875:Middle Aged
D003287:Contrast Media; D019786:Gadolinium DTPA