title: Radiologic-Pathologic Discordance and Outcome After MRI-Guided Vacuum-Assisted Biopsy.
abstract: OBJECTIVE
  The purpose of this study was to determine the rate, characteristics, and outcomes of discordant MRI-guided vacuum-assisted biopsy (VAB) in women with suspected breast cancer.
  
  
  METHODS
  This retrospective study reviewed 1314 MRI-guided VABs performed in 1211 women between 2007 and 2013 and yielded 25 discordant results in 24 women. MRI characteristics; BI-RADS assessments; whether the lesion was missed, partially sampled, or excised at biopsy; and biopsy and surgical pathology results were reviewed. Statistical analyses were performed using Fisher exact and Mann-Whitney U tests.
  
  
  RESULTS
  Among 1314 lesions that underwent MRI-guided VAB, 25 results were discordant (1.9%; 95% CI, 1.2-2.8%), and nine lesions with discordant results (36.0%, 95% CI, 18.5-56.9%) were malignant at surgical excision (three invasive ductal carcinoma and six ductal carcinoma in situ). There was no significant association between malignancy and lesion type, size, enhancement pattern, BI-RADS assessment, or clinical indication. Forty-four percent (11/25) of discordant lesions were missed, 48.0% (12/25) were partially sampled, and 8.0% (2/25) appeared to have been excised. Of the nine malignant lesions, 44.4% (4/9) discordant malignant lesions were missed, 44.4% (4/9) were partially sampled, and 11.1% (1/9) appeared to have been excised. Lesion sizes and types were similar in the missed and partially excised groups.
  
  
  CONCLUSIONS
  The potential for false-negative results at MRI-guided VAB underscores the importance of radiologic-histologic correlation and imaging review after biopsy. Rebiopsy or excision in discordant cases is therefore recommended.
authors: 1 Department of Radiology, New York University School of Medicine, Center for Biomedical Imaging, 660 First Ave, 4th Fl, New York, NY 10016.
authors: Alana A
authors: AA
authors: Lewin
authors: 2 Department of Radiology, New York University School of Medicine, Laura and Isaac Perlmutter Cancer Center, New York, NY.
authors: Samantha L
authors: SL
authors: Heller
authors: 2 Department of Radiology, New York University School of Medicine, Laura and Isaac Perlmutter Cancer Center, New York, NY.
authors: Sonam
authors: S
authors: Jaglan
authors: 2 Department of Radiology, New York University School of Medicine, Laura and Isaac Perlmutter Cancer Center, New York, NY.
authors: Kristin
authors: K
authors: Elias
authors: 2 Department of Radiology, New York University School of Medicine, Laura and Isaac Perlmutter Cancer Center, New York, NY.
authors: Adrienne
authors: A
authors: Newburg
authors: 2 Department of Radiology, New York University School of Medicine, Laura and Isaac Perlmutter Cancer Center, New York, NY.
authors: Amy
authors: A
authors: Melsaether
authors: 2 Department of Radiology, New York University School of Medicine, Laura and Isaac Perlmutter Cancer Center, New York, NY.
authors: Linda
authors: L
authors: Moy
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D053783:Magnetic Resonance Imaging, Interventional / Q000706:statistics & numerical data*; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: MRI; breast cancer; discordance; vacuum-assisted biopsy