title: Imaging-Concordant Benign MRI-Guided Vacuum-Assisted Breast Biopsy May Not Warrant MRI Follow-Up.
abstract: OBJECTIVE
  The follow-up of breast lesions with imaging-concordant benign histopathology results on MRI-guided vacuum-assisted biopsy (VAB) is not currently standardized. We determined the false omission rate of breast MRI-guided VAB with benign histopathology (negative results) to assess whether breast MRI follow-up is needed.
  
  
  METHODS
  The medical records of patients who underwent 9-gauge breast MRI-guided VAB during 2007-2012 were reviewed retrospectively. Lesions with imaging-concordant benign histopathology results from MRI-guided VAB and surgery or 2 years or more of imaging follow-up were included. The false omission rate (1 - negative predictive value; [number of false-negative results / number of negative results]) of MRI-guided VAB was calculated.
  
  
  RESULTS
  One hundred sixty-nine lesions were included, and 135 had only imaging follow-up (mammography follow-up: range, 17-107 months [median, 52 months]; MRI follow-up: range, 5-95 months [median, 35 months]). Of the 135 lesions with only imaging follow-up, 48 had mammography only (range, 26-86 months; median, 52 months), and 87 had mammography (range, 17-107 months; median, 52 months) and MRI (range, 5-95 months; median, 35 months). Thirty-four lesions had surgical correlation, and there were no cases of imaging-surgical discordance. Four malignancies were later diagnosed in the same breast in which MRI-guided VAB had been performed. One (0.6%) malignancy was invasive ductal carcinoma at 1 cm from the MRI-guided VAB site; it was mammographically detected 24 months after MRI-guided VAB. The other three malignancies developed 4 cm or more from the site of MRI-guided VAB: one ductal carcinoma in situ (DCIS) detected on mammography 12 months after MRI-guided VAB, one DCIS detected on MRI 24 months after MRI-guided VAB, and one Paget disease lesion detected at physical examination 32 months after MRI-guided VAB.
  
  
  CONCLUSIONS
  Breast MRI-guided VAB has a low false omission rate. MRI follow-up of lesions with concordant benign MRI-guided VAB histopathology results may not be warranted.
authors.affiliation: 1 Department of Diagnostic Radiology, Section of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.
authors.forename: Monica L
authors.initials: ML
authors.lastname: Huang
authors.affiliation: 1 Department of Diagnostic Radiology, Section of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.
authors.forename: Megan
authors.initials: M
authors.lastname: Speer
authors.affiliation: 2 Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Basak E
authors.initials: BE
authors.lastname: Dogan
authors.affiliation: 1 Department of Diagnostic Radiology, Section of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.
authors.forename: Gaiane M
authors.initials: GM
authors.lastname: Rauch
authors.affiliation: 1 Department of Diagnostic Radiology, Section of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.
authors.forename: Rosalind P
authors.initials: RP
authors.lastname: Candelaria
authors.affiliation: 1 Department of Diagnostic Radiology, Section of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.
authors.forename: Beatriz E
authors.initials: BE
authors.lastname: Adrada
authors.affiliation: 3 Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Hess
authors.affiliation: 1 Department of Diagnostic Radiology, Section of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.
authors.forename: Wei T
authors.initials: WT
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008137:Longitudinal Studies; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: MRI-guided; benign; breast; imaging-concordant; vacuum-assisted breast biopsy