title: MR-guided vacuum-assisted breast biopsy of MRI-only lesions: a single center experience.
abstract: OBJECTIVE
  The purpose of this study was to compare three different biopsy devices on false-negative and underestimation rates in MR-guided, vacuum-assisted breast biopsy (VABB) of MRI-only lesions.
  
  
  METHODS
  This retrospective, single-center study was IRB-approved. Informed consent was waived. 467 consecutive patients underwent 487 MR-guided VABB using three different 8-10-gauge-VABB devices (Atec-9-gauge,A; Mammotome-8-gauge,M; Vacora-10-gauge,V). VABB data (lesion-type, size, biopsy device, histopathology) were compared to final diagnosis (surgery, n = 210 and follow-up, n = 277). Chi-square, and Kruskal-Wallis tests were applied. P values < 0.05 were considered significant.
  
  
  RESULTS
  Final diagnosis was malignant in 104 (21.4 %), high risk in 64 (13.1 %) and benign in 319 (65.5 %) cases. Eleven of 328 (3.4 %) benign-rated lesions were false-negative (1/95, 1.1 %, A; 2/73, 2.7 %, M; 8/160 5.0 % V; P = 0.095). Eleven high-risk (11/77, 14.3 %) lesions proved to be malignant (3/26, 11.5 % A; 4/12, 33.3 % M; 4/39, 10.3 % V; P = 0.228). Five of 34 (14.7 %) DCIS were upgraded to invasive cancer (2/15, 13.3 %, A; 1/6, 16.6 % M; 2/13, 15.3 %, V; P = 0.977). Lesion size (P = 0.05) and type (mass vs. non-mass, P = 0.107) did not differ significantly.
  
  
  CONCLUSIONS
  MR-guided VABB is an accurate method for diagnosis of MRI-only lesions. No significant differences on false-negative and underestimation rates were observed between three different biopsy devices.
  
  
  CONCLUSIONS
  • MR-guided VABB is an accurate procedure for the diagnosis of MRI-only lesions. • Similar false-negative and underestimation rates allow all three different MR-guided VABB devices for clinical application. • High-risk lesions should undergo surgery due to a substantial underestimation rate. • Agreement between MR-guided VABB and final diagnosis (benign/malignant) was 95.5% (465/487).
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna (AKH), Waehringer Gürtel 18-20, Floor 7F, A-1090, Wien, Austria.
authors.forename: Claudio
authors.initials: C
authors.lastname: Spick
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna (AKH), Waehringer Gürtel 18-20, Floor 7F, A-1090, Wien, Austria.
authors.forename: Melanie
authors.initials: M
authors.lastname: Schernthaner
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna (AKH), Waehringer Gürtel 18-20, Floor 7F, A-1090, Wien, Austria.
authors.forename: Katja
authors.initials: K
authors.lastname: Pinker
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna (AKH), Waehringer Gürtel 18-20, Floor 7F, A-1090, Wien, Austria.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kapetas
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna (AKH), Waehringer Gürtel 18-20, Floor 7F, A-1090, Wien, Austria.
authors.forename: Maria
authors.initials: M
authors.lastname: Bernathova
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna (AKH), Waehringer Gürtel 18-20, Floor 7F, A-1090, Wien, Austria.
authors.forename: Stephan H
authors.initials: SH
authors.lastname: Polanec
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna (AKH), Waehringer Gürtel 18-20, Floor 7F, A-1090, Wien, Austria.
authors.forename: Hubert
authors.initials: H
authors.lastname: Bickel
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna (AKH), Waehringer Gürtel 18-20, Floor 7F, A-1090, Wien, Austria.
authors.forename: Georg J
authors.initials: GJ
authors.lastname: Wengert
authors.affiliation: Clinical Institute of Pathology, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, A-1090, Wien, Austria.
authors.forename: Margaretha
authors.initials: M
authors.lastname: Rudas
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna (AKH), Waehringer Gürtel 18-20, Floor 7F, A-1090, Wien, Austria. thomas.helbich@meduniwien.ac.at.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Helbich
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna (AKH), Waehringer Gürtel 18-20, Floor 7F, A-1090, Wien, Austria.
authors.forename: Pascal A
authors.initials: PA
authors.lastname: Baltzer
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D014618:Vacuum
keywords: Breast cancer; MR imaging; MR-guided biopsy; MRI-only lesions; Vacuum assisted breast biopsy