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Outcome of MRI-guided vacuum-assisted breast biopsy - initial experience at Institute of Oncology Ljubljana, Slovenia.

Zebic-Sinkovec M, Hertl K, Kadivec M, Cavlek M, Podobnik G, Snoj M - Radiol Oncol (2012)

Bottom Line: MRI guided procedures (needle biopsy, presurgical localisation) are mandatory for suspicious findings visible only at MRI, with potential influence on therapeutic decision.We evaluated the MRI findings that led to biopsy and we investigated the core and postoperative histology results and follow-up data.The biopsy was technically successful in 14 (93%) of 15 women.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.

ABSTRACT

Background: Like all breast imaging modalities MRI has limited specificity and the positive predictive value for lesions detected by MRI alone ranges between 15 and 50%. MRI guided procedures (needle biopsy, presurgical localisation) are mandatory for suspicious findings visible only at MRI, with potential influence on therapeutic decision. The aim of this retrospective study was to evaluate our initial clinical experience with MRI-guided vacuum-assisted breast biopsy as an alternative to surgical excision and to investigate the outcome of MRI-guided breast biopsy as a function of the MRI features of the lesions. PATIENTS AND METHODS.: In 14 women (median age 51 years) with 14 MRI-detected lesions, MRI-guided vacuum-assisted breast biopsy was performed. We evaluated the MRI findings that led to biopsy and we investigated the core and postoperative histology results and follow-up data.

Results: The biopsy was technically successful in 14 (93%) of 15 women. Of 14 biopsies in 14 women, core histology revealed 6 malignant (6/14, 43%), 6 benign (6/14, 43%) and 2 high-risk (2/14, 14%) lesions. Among the 6 cancer 3 were invasive and 3 were ductal carcinoma in situ (DCIS). The probability of malignancy in our experience was higher for non-mass lesion type and for washout and plateau kinetics.

Conclusions: Our initial experience confirms that MRI-guided vacuum-assisted biopsy is fast, safe and accurate alternative to surgical biopsy for breast lesions detected at MRI only.

No MeSH data available.


Related in: MedlinePlus

63-year old woman with history of invasive ductal carcinoma in her right breast 8 years ago. Clinical exam revealed enlarged lymph node in the left axilla. Fine needle aspiration biopsy showed metastatic lymph node. Mammographically discrete architectural distortion only in one projection in the left and postoperative changes in the right breast. Ultrasound was not performed at the discretion of the radiologist. Axial T1-weighted subtracted image after Gadolinium injection (2nd minute) shows focal, heterogeneous, asymmetric, non–mass like enhancement in the left breast, the kinetic curve shows fast initial enhancement with post-initial wash out, low signal intensity on T2-weighted images – BI-RADS 4. MRI–guided vacuum-assisted biopsy revealed invasive lobular carcinoma.
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f9-rado-46-02-97: 63-year old woman with history of invasive ductal carcinoma in her right breast 8 years ago. Clinical exam revealed enlarged lymph node in the left axilla. Fine needle aspiration biopsy showed metastatic lymph node. Mammographically discrete architectural distortion only in one projection in the left and postoperative changes in the right breast. Ultrasound was not performed at the discretion of the radiologist. Axial T1-weighted subtracted image after Gadolinium injection (2nd minute) shows focal, heterogeneous, asymmetric, non–mass like enhancement in the left breast, the kinetic curve shows fast initial enhancement with post-initial wash out, low signal intensity on T2-weighted images – BI-RADS 4. MRI–guided vacuum-assisted biopsy revealed invasive lobular carcinoma.


Outcome of MRI-guided vacuum-assisted breast biopsy - initial experience at Institute of Oncology Ljubljana, Slovenia.

Zebic-Sinkovec M, Hertl K, Kadivec M, Cavlek M, Podobnik G, Snoj M - Radiol Oncol (2012)

63-year old woman with history of invasive ductal carcinoma in her right breast 8 years ago. Clinical exam revealed enlarged lymph node in the left axilla. Fine needle aspiration biopsy showed metastatic lymph node. Mammographically discrete architectural distortion only in one projection in the left and postoperative changes in the right breast. Ultrasound was not performed at the discretion of the radiologist. Axial T1-weighted subtracted image after Gadolinium injection (2nd minute) shows focal, heterogeneous, asymmetric, non–mass like enhancement in the left breast, the kinetic curve shows fast initial enhancement with post-initial wash out, low signal intensity on T2-weighted images – BI-RADS 4. MRI–guided vacuum-assisted biopsy revealed invasive lobular carcinoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3472934&req=5

f9-rado-46-02-97: 63-year old woman with history of invasive ductal carcinoma in her right breast 8 years ago. Clinical exam revealed enlarged lymph node in the left axilla. Fine needle aspiration biopsy showed metastatic lymph node. Mammographically discrete architectural distortion only in one projection in the left and postoperative changes in the right breast. Ultrasound was not performed at the discretion of the radiologist. Axial T1-weighted subtracted image after Gadolinium injection (2nd minute) shows focal, heterogeneous, asymmetric, non–mass like enhancement in the left breast, the kinetic curve shows fast initial enhancement with post-initial wash out, low signal intensity on T2-weighted images – BI-RADS 4. MRI–guided vacuum-assisted biopsy revealed invasive lobular carcinoma.
Bottom Line: MRI guided procedures (needle biopsy, presurgical localisation) are mandatory for suspicious findings visible only at MRI, with potential influence on therapeutic decision.We evaluated the MRI findings that led to biopsy and we investigated the core and postoperative histology results and follow-up data.The biopsy was technically successful in 14 (93%) of 15 women.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.

ABSTRACT

Background: Like all breast imaging modalities MRI has limited specificity and the positive predictive value for lesions detected by MRI alone ranges between 15 and 50%. MRI guided procedures (needle biopsy, presurgical localisation) are mandatory for suspicious findings visible only at MRI, with potential influence on therapeutic decision. The aim of this retrospective study was to evaluate our initial clinical experience with MRI-guided vacuum-assisted breast biopsy as an alternative to surgical excision and to investigate the outcome of MRI-guided breast biopsy as a function of the MRI features of the lesions. PATIENTS AND METHODS.: In 14 women (median age 51 years) with 14 MRI-detected lesions, MRI-guided vacuum-assisted breast biopsy was performed. We evaluated the MRI findings that led to biopsy and we investigated the core and postoperative histology results and follow-up data.

Results: The biopsy was technically successful in 14 (93%) of 15 women. Of 14 biopsies in 14 women, core histology revealed 6 malignant (6/14, 43%), 6 benign (6/14, 43%) and 2 high-risk (2/14, 14%) lesions. Among the 6 cancer 3 were invasive and 3 were ductal carcinoma in situ (DCIS). The probability of malignancy in our experience was higher for non-mass lesion type and for washout and plateau kinetics.

Conclusions: Our initial experience confirms that MRI-guided vacuum-assisted biopsy is fast, safe and accurate alternative to surgical biopsy for breast lesions detected at MRI only.

No MeSH data available.


Related in: MedlinePlus