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Initial experience with magnetic resonance-guided vacuum-assisted biopsy in korean women with breast cancer.

Jung HN, Han BK, Ko EY, Shin JH - J Breast Cancer (2014)

Bottom Line: VAB histology was compared with surgical histology and follow-up imaging findings.In the remaining 10 lesions, follow-up breast ultrasound and mammography were available (range, 15-44 months; mean, 32.1 months) and did not show suspicious lesions.MR-guided VAB helps surgeons avoid an unnecessary wide excision or additional excisional biopsy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The aim of this study is to describe our initial experience with magnetic resonance (MR)-guided biopsy and to determine the malignancy rate of additional lesions identified by MR only in Korean women with breast cancer.

Methods: A retrospective review identified 22 consecutive patients with breast cancer who had undergone MR-guided vacuum-assisted biopsies (VAB) of MR-only identified lesions from May 2009 to October 2011.We evaluated the rate of compliance, the technical success for MR-guided VAB and the MR imaging findings of the target lesions. VAB histology was compared with surgical histology and follow-up imaging findings.

Results: The biopsy recommendations for MR-only identified lesions were accepted in 46.8% (22/47) of patients. One of 22 procedures failed due to the target's posterior location. Among 21 MR-guided VAB procedures, the target lesions were considered as a mass in 12 cases and a nonmass enhancement in nine cases. VAB histology revealed malignancies in 14% (3/21) of cases, high-risk lesions in 24% (5/21) and benign lesions in 62% (13/21). Eleven cases (52%, 11/21) had a positive surgical correlation, and one of them was upgraded from atypical ductal hyperplasia to invasive ductal carcinoma. In the remaining 10 lesions, follow-up breast ultrasound and mammography were available (range, 15-44 months; mean, 32.1 months) and did not show suspicious lesions. The final malignancy rate was 19% (4/21).

Conclusion: MR-guided VAB for MR-only identified lesions yielded a 19% malignancy rate in Korean women with breast cancer. MR-guided VAB helps surgeons avoid an unnecessary wide excision or additional excisional biopsy.

No MeSH data available.


Related in: MedlinePlus

Flowchart for additional suspicious lesions on magnetic resonance imaging (MRI) in patients with breast cancer who underwent preoperative breast MRI and surgeries.US=ultrasound.
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Figure 1: Flowchart for additional suspicious lesions on magnetic resonance imaging (MRI) in patients with breast cancer who underwent preoperative breast MRI and surgeries.US=ultrasound.

Mentions: From May 2009 to October 2011, breast cancer surgeries were performed on 3,561 patients at our institution. Of them, 3,208 patients underwent preoperative breast MR imaging. In 234 of the 3,208 patients (7%), additional suspicious lesions were detected and the location of lesions could affect the method of the breast cancer surgery. Because the surgeons prefer US-guided procedures due to the lack of wait time, we considered second-look US ahead of MR-guided VAB to verify the lesion's identity; MR-guided VAB was only recommended when it was difficult to localize the lesion with US. Therefore, second-look US was recommended in 187 patients (80%, 187/234) and MR-guided breast VAB was recommended in 47 patients (20%, 47/234). Among them, 22 patients (9%, 22/234) underwent MR-guided breast VABs. All patients were Korean. Figure 1 shows a flowchart for the 3,208 patients who underwent preoperative breast MR imaging.


Initial experience with magnetic resonance-guided vacuum-assisted biopsy in korean women with breast cancer.

Jung HN, Han BK, Ko EY, Shin JH - J Breast Cancer (2014)

Flowchart for additional suspicious lesions on magnetic resonance imaging (MRI) in patients with breast cancer who underwent preoperative breast MRI and surgeries.US=ultrasound.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4197358&req=5

Figure 1: Flowchart for additional suspicious lesions on magnetic resonance imaging (MRI) in patients with breast cancer who underwent preoperative breast MRI and surgeries.US=ultrasound.
Mentions: From May 2009 to October 2011, breast cancer surgeries were performed on 3,561 patients at our institution. Of them, 3,208 patients underwent preoperative breast MR imaging. In 234 of the 3,208 patients (7%), additional suspicious lesions were detected and the location of lesions could affect the method of the breast cancer surgery. Because the surgeons prefer US-guided procedures due to the lack of wait time, we considered second-look US ahead of MR-guided VAB to verify the lesion's identity; MR-guided VAB was only recommended when it was difficult to localize the lesion with US. Therefore, second-look US was recommended in 187 patients (80%, 187/234) and MR-guided breast VAB was recommended in 47 patients (20%, 47/234). Among them, 22 patients (9%, 22/234) underwent MR-guided breast VABs. All patients were Korean. Figure 1 shows a flowchart for the 3,208 patients who underwent preoperative breast MR imaging.

Bottom Line: VAB histology was compared with surgical histology and follow-up imaging findings.In the remaining 10 lesions, follow-up breast ultrasound and mammography were available (range, 15-44 months; mean, 32.1 months) and did not show suspicious lesions.MR-guided VAB helps surgeons avoid an unnecessary wide excision or additional excisional biopsy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The aim of this study is to describe our initial experience with magnetic resonance (MR)-guided biopsy and to determine the malignancy rate of additional lesions identified by MR only in Korean women with breast cancer.

Methods: A retrospective review identified 22 consecutive patients with breast cancer who had undergone MR-guided vacuum-assisted biopsies (VAB) of MR-only identified lesions from May 2009 to October 2011.We evaluated the rate of compliance, the technical success for MR-guided VAB and the MR imaging findings of the target lesions. VAB histology was compared with surgical histology and follow-up imaging findings.

Results: The biopsy recommendations for MR-only identified lesions were accepted in 46.8% (22/47) of patients. One of 22 procedures failed due to the target's posterior location. Among 21 MR-guided VAB procedures, the target lesions were considered as a mass in 12 cases and a nonmass enhancement in nine cases. VAB histology revealed malignancies in 14% (3/21) of cases, high-risk lesions in 24% (5/21) and benign lesions in 62% (13/21). Eleven cases (52%, 11/21) had a positive surgical correlation, and one of them was upgraded from atypical ductal hyperplasia to invasive ductal carcinoma. In the remaining 10 lesions, follow-up breast ultrasound and mammography were available (range, 15-44 months; mean, 32.1 months) and did not show suspicious lesions. The final malignancy rate was 19% (4/21).

Conclusion: MR-guided VAB for MR-only identified lesions yielded a 19% malignancy rate in Korean women with breast cancer. MR-guided VAB helps surgeons avoid an unnecessary wide excision or additional excisional biopsy.

No MeSH data available.


Related in: MedlinePlus