title: MR imaging-guided vacuum-assisted breast biopsy: reduction of false-negative biopsies by short-term control MRI 24-48 h after biopsy.
abstract: OBJECTIVE
  To evaluate whether another contrast-enhanced (CE) magnetic resonance imaging (MRI) examination 24-48 h after MRI-guided vacuum-assisted breast biopsy (MRI-VAB) can reduce the rate of false-negative cases.
  
  
  METHODS
  The study included 252 patients who underwent MRI-VAB for the clarification of 299 lesions. The success of MRI-VAB was assessed at interventional MRI and another CE MRI 24-48 h after the intervention. In cases of successful MRI-VAB (complete or partial lesion removal) and benign histological results, follow-up breast MRI was performed. In cases of unsuccessful biopsy (unchanged lesion), tissue sampling was repeated. False-negative cases were calculated to assess the diagnostic value of MRI follow-up within 2 days after intervention.
  
  
  RESULTS
  Ninety-eight malignant (32.8%) and 201 (67.2%) benign lesions were diagnosed using MRI-VAB. At immediate unenhanced control MRI, all lesions were assessed as successfully biopsied. In 18 benign cases (6%), CE MRI after 24-48 h showed an unsuccessful intervention. Further tissue sampling revealed another 13 cancers in these patients. This results in a false-negative rate of 11.7%. Follow-up MRI of the benign lesions presented no further malignancy.
  
  
  CONCLUSIONS
  MRI-VAB with immediate unenhanced control offers a success rate of 94%. The rate of false-negative biopsies (11.7%) could be reduced to zero by using short-term follow-up MRI. Therefore, a further CE breast MRI 24-48 h after benign MRI-VAB to eliminate missed cancers is recommended.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Germany. Electronic address: sonja.bahrs@med.uni-tuebingen.de.
authors.forename: S D
authors.initials: SD
authors.lastname: Bahrs
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Hattermann
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Preibsch
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Tuebingen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hahn
authors.affiliation: Institute of Pathology and Neuropathology, University Hospital Tuebingen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Staebler
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Germany.
authors.forename: C D
authors.initials: CD
authors.lastname: Claussen
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Germany.
authors.forename: K C
authors.initials: KC
authors.lastname: Siegmann-Luz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014463:Ultrasonography; D014618:Vacuum