Magnetic resonance-guided, vacuum-assisted breast biopsy: results from a European multicenter study of 538 lesions.
BACKGROUND
The objective of this study was to determine the accuracy, reproducibility, and clinical value of magnetic resonance (MR)-guided, vacuum-assisted breast biopsy (MR-VAB) in a prospective, multicenter study.


METHODS
In 5 European centers, MR-VAB was performed or attempted on 538 suspicious lesions that were visible or could targeted only by MR imaging (MRI). Verification of malignant or borderline lesions included reexcision of the biopsy cavity. Benign biopsy results were verified by retrospective correlation of histology with preinterventional and postinterventional MRI studies. Follow-up of 24-48 months (median, 32 months) was available for 491 of 538 patients.


RESULTS
MR-VAB was unsuccessful or was not completed in 21 of 538 patients, for which an immediate repeat biopsy was recommended. Five hundred seventeen of 538 performed VAB procedures (96%) were successful. Histology yielded 138 (27%) malignancies, 17 (3%) atypical ductal hyperplasias, and 362 (70%) benign entities. No false-negative diagnoses occurred among the 517 successful MR-VAB procedures. The positive predictive value of VAB depended on patient preselection, which differed according to the indication for the initial MRI study.


CONCLUSIONS
The results of this study indicated that MR-VAB offers excellent accuracy. Small lesion size did not prove to be a limitation.
Perlet
Claudia
C
Department of Breast Imaging and Intervention; Radiology, Klinikum Rechts der Isar, Technical University Munich, Germany. claudia.perlet@med.uni-muenchen.de
Heywang-Kobrunner
Sylvia H
SH
Heinig
Anke
A
Sittek
Harald
H
Casselman
Jan
J
Anderson
Ingvar
I
Taourel
Patrick
P
D001706:Biopsy / Q000379:methods; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014618:Vacuum