title: Vacuum-assisted biopsies under MR guidance: results of 72 procedures.
abstract: OBJECTIVE
  To investigate the clinical accuracy of magnetic resonance imaging-guided breast vacuum-assisted biopsy (MR-VAB).
  
  
  METHODS
  Of 97 scheduled MR-VAB for single MRI lesions (negative second-look sonography) categorised as BI-RADS 4 or 5, 4 were cancelled (undetected lesion = 2, technical problems = 2). Twenty-one patients lost to follow-up were excluded.
  
  
  RESULTS
  Twenty-three patients (median age 51 years) were at high risk (BRCA1 = 11, BRCA2 = 7, familial risk = 5), 23 had a suspected local recurrence of breast cancer. Seventy-two imaged lesions (focus = 1, mass enhancement = 32, non-mass-like enhancement = 39) were targeted with a 10-gauge VAB probe using MRI guidance, with a median of 18 specimens per lesion (median procedural time 72 min, range 50-131 min) followed by clip placement. In the case of benignity, MRI follow-up was performed (19 patients, median 389 days, range 33-1,592) or mammography (3 patients, median 420 days, range 372-1,354). According to histopathology results, 29 lesions were benign, 10 were high-risk (papillary = 2, radial scar = 1, atypical epithelial hyperplasia = 7) and 33 malignant (ductal carcinoma in situ = 8, invasive cancers = 25). Three false negative results and 3 complications occurred (1 malaise, 1 skin defect, 1 infection).
  
  
  CONCLUSIONS
  MRI-guided VAB represents an accurate tool for the histological diagnosis of lesions visible only at MRI.
authors.affiliation: Radiology Department, Institut Curie, Paris, France. caroline.malhaire@curie.net
authors.forename: C
authors.initials: C
authors.lastname: Malhaire
authors.forename: C
authors.initials: C
authors.lastname: El Khoury
authors.forename: F
authors.initials: F
authors.lastname: Thibault
authors.forename: A
authors.initials: A
authors.lastname: Athanasiou
authors.forename: P
authors.initials: P
authors.lastname: Petrow
authors.forename: L
authors.initials: L
authors.lastname: Ollivier
authors.forename: A
authors.initials: A
authors.lastname: Tardivon
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D001706:Biopsy; D001761:Bleomycin; D001940:Breast / Q000601:surgery; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003609:Dactinomycin; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D011859:Radiography; D012189:Retrospective Studies; D047368:Tumor Burden; D014618:Vacuum; D014747:Vinblastine
chemical_list: D001761:Bleomycin; D003609:Dactinomycin; D014747:Vinblastine