title: MR-guided vacuum-assisted breast biopsy in the management of incidental enhancing lesions detected by breast MR imaging.
abstract: OBJECTIVE
  The objective of this study was to determine the clinical value and accuracy of magnetic resonance (MR)-guided vacuum-assisted breast biopsy (VAB).
  
  
  METHODS
  We retrospectively analysed 106 incidental breast lesions detected on MR imaging in 98 patients. Patients with nonpalpable suspicious lesions that were only MR visible were referred for MR-VAB performed with a 10-gauge needle. All patients with a VAB diagnosis of infiltrating carcinoma, carcinoma in situ or atypical epithelial hyperplasia were referred for surgery. Histopathology of the surgical specimen was considered the reference standard.
  
  
  RESULTS
  MR-guided VAB was attempted in 29/106 lesions (27%); in 2/29 patients, the procedure could not be performed owing to failure to visualise the lesion. Lesions with clearly malignant features and borderline lesions (atypical ductal hyperplasias) were identified in 12 cases (44%) and benign entities in 15 (56%). Seven of 12 (58%) malignant lesions were <10 mm. Among the 27 successful MR-VAB procedures, VAB yielded one false-negative diagnosis (4%) and underestimation (4%). MR-guided VAB sensitivity and specificity were 92% and 100%, respectively, with a positive predictive value of 100% and a negative predictive value of 93%.
  
  
  CONCLUSIONS
  The results of this study indicate that MR-guided VAB offers good accuracy in characterising nonpalpable breast lesions visible on MR imaging alone. Small lesion size (<1 cm) did not prove to be a limitation for the success of the procedure.
authors.affiliation: Dipartimento di Radiologia, Policlinico Universitario "G.B. Rossi", P.le L.A. Scuro 10, 37134 Verona, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Carbognin
authors.forename: V
authors.initials: V
authors.lastname: Girardi
authors.forename: A
authors.initials: A
authors.lastname: Brandalise
authors.forename: I
authors.initials: I
authors.lastname: Baglio
authors.forename: A
authors.initials: A
authors.lastname: Bucci
authors.forename: F
authors.initials: F
authors.lastname: Bonetti
authors.forename: R
authors.initials: R
authors.lastname: Pozzi Mucelli
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D018567:Breast Neoplasms, Male / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D033162:Incidental Findings; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media