title: Real-time virtual sonography examination and biopsy for suspicious breast lesions identified on MRI alone.
abstract: OBJECTIVE
  The purpose of our study was to assess whether there is a potential additional value of real-time virtual sonography (RVS) to second-look ultrasound (US) examination and biopsy for breast lesions identified on MRI alone.
  
  
  METHODS
  A retrospective review of the records of 70 consecutive patients (78 lesions) with breast abnormalities identified on MRI alone was performed. All suspicious enhancing lesions were subsequently evaluated with second-look US. Lesions not observed on second-look US underwent RVS. Pathological findings were confirmed by subsequent percutaneous biopsy or excision.
  
  
  RESULTS
  Of the 78 MRI-detected lesions, second-look US correlation was made in 50 (64 %), including 22 malignant and 28 benign lesions. The remaining 28 lesions (36 %) were scheduled to undergo RVS. Four lesions were not visible on the second breast MRI. The remaining 24 lesions were RVS correlated and underwent RVS-guided biopsy; these included seven malignant and 17 benign lesions. Overall, 74 of 74 (100 %) true MRI-detected lesions were confirmed by histological results without using MRI-guided breast biopsy. The cancer rate was 29 %.
  
  
  CONCLUSIONS
  RVS can increase the sonographic detection and biopsy rate of lesions identified on breast MRI alone.
  
  
  CONCLUSIONS
  • All 74 MRI-detected lesions were confirmed without using MRI-guided biopsy. • Four lesions were not visible on second breast MRI. • RVS can increase sonographic detection of lesions identified on breast MRI alone. • RVS-guided breast biopsy can be an alternative to MRI-guided biopsy.
authors.affiliation: Breast Imaging and Breast Intervention Section, Department of Clinical Physiology, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan. t.uematsu@scchr.jp.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Uematsu
authors.affiliation: Department of Breast Surgery, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Breast Surgery, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan.
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Nishimura
authors.affiliation: Department of Breast Oncology, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan.
authors.forename: Junichiro
authors.initials: J
authors.lastname: Watanabe
authors.affiliation: Department of Multidisciplinary Therapy for Breast Cancer, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Yamasaki
authors.affiliation: Department of Pathology, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sugino
authors.affiliation: Department of Pathology, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Oishi
authors.affiliation: Department of Pathology, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kakuda
authors.affiliation: Department of Breast Surgery, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan.
authors.forename: Mutsu
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Breast Surgery, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology; D001941:Breast Diseases / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000379:methods*; D016217:Ultrasonography, Mammary / Q000379:methods*
keywords: Breast lesions identified on MRI alone; Real-time virtual sonography; Second-look ultrasound; Supine breast MRI; Vacuum-assisted breast biopsy