title: Magnetic resonance imaging-guided biopsy of mammographically and clinically occult breast lesions.
abstract: BACKGROUND
  Breast magnetic resonance imaging (MRI) is a very sensitive technique for detection of breast cancer. We report on MRI-guided needle localization for biopsy of abnormalities seen only on MRI.
  
  
  METHODS
  A retrospective review was performed of 231 patients with invasive breast cancer or ductal carcinoma-in-situ who had MRI as part of their evaluation and treatment at the University of Pennsylvania between 1992 and 1998. Clinical, radiological, and pathologic data were examined.
  
  
  RESULTS
  MRI needle localization was performed in 41 (18%) patients. MRI needle localization was required for a finding of a mammographically or clinically occult lesion in 31 patients, better MRI definition of tumor in 5 patients, and surgeon's choice in 5 patients. In all cases, MRI localization and excisional biopsy were successfully completed. Nineteen of 31 patients were found to have additional mammographically and clinically occult tumors. There were 12 (29%) false-positive MRI scans.
  
  
  CONCLUSIONS
  MRI has a high sensitivity for detection of breast cancer; additional mammographically and clinically occult sites of tumor are detected in approximately 1 (15%) of 7 breast cancer patients. These otherwise occult sites of disease can be appropriately biopsied with MRI needle-localization techniques.
authors.affiliation: Department of Surgery, University of Pennsylvania, 4 Silverstein, HUP, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bedrosian
authors.forename: James
authors.initials: J
authors.lastname: Schlencker
authors.forename: Francis R
authors.initials: FR
authors.lastname: Spitz
authors.forename: Susan G
authors.initials: SG
authors.lastname: Orel
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Fraker
authors.forename: Linda S
authors.initials: LS
authors.lastname: Callans
authors.forename: Mitchell
authors.initials: M
authors.lastname: Schnall
authors.forename: Carol
authors.initials: C
authors.lastname: Reynolds
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Czerniecki
mesh_terms: D001706:Biopsy / Q000379:methods; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000473:pathology*; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity