title: Patient outcomes in canceled MRI-guided breast biopsies.
abstract: OBJECTIVE
  The reported frequency of aborted MRI-guided breast biopsies ranges from 8% to 17%, usually secondary to nonvisualization at attempted biopsy. Our study examines the frequency of MRI-guided breast biopsies aborted because of lesion nonvisualization and the subsequent risk of malignancy.
  
  
  METHODS
  We identified 350 patients and 445 lesions scheduled for MRI-guided biopsy between January 1, 2007, and December 31, 2009. Medical records and imaging studies were reviewed to ascertain patient demographics, lesion and imaging characteristics, and subsequent pathology results. Chi-square statistics were calculated for patient level analyses.
  
  
  RESULTS
  MRI-guided biopsies were aborted in 13% (56/445) of lesions and 15% (53/350; 95% CI, 11.6-19.3%) of patients because of nonvisualization of the biopsy target at the time of attempted biopsy. Of these 53 patients, 50 patients had follow-up data available. Malignancy was subsequently diagnosed in five of those 50 patients (10%; 95% CI, 3.3-21.8%), three with invasive ductal carcinomas and two with ductal carcinoma in situ. The mean time to malignant diagnosis from the date of aborted biopsy was 2.6 months (range, 1.1-6.9 months).
  
  
  CONCLUSIONS
  Informed consent for MRI-guided breast biopsies should include discussion of biopsy cancellation because of nonvisualization of the target lesion. The low yet significant risk of malignancy in patients subsequent to an aborted MRI-guided breast biopsy warrants short-term follow-up MRI after a canceled biopsy.
authors.affiliation: 1 Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, 55 Fruit St, Wang Bldg, Ste 240, Boston, MA 02114.
authors.forename: Bethany L
authors.initials: BL
authors.lastname: Niell
authors.forename: Janie M
authors.initials: JM
authors.lastname: Lee
authors.forename: Christopher
authors.initials: C
authors.lastname: Johansen
authors.forename: Elkan F
authors.initials: EF
authors.lastname: Halpern
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Rafferty
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology*; D004868:Equipment Failure; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D006801:Humans; D007258:Informed Consent; D053783:Magnetic Resonance Imaging, Interventional; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D017211:Treatment Failure