Limits...
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

Images of a 49-year-old woman with diagnosed as ductal carcinoma in situ (DCIS) in the left breast. (A) Initial diagnostic contrast enhanced sagittal T1-weighted 3D turbo field-echo image shows segmental enhancing lesion without washout in the mid-outer region of the contralateral (right) breast (arrow). Mammograms and second-look ultrasound did not show clear relation with magnetic resonance (MR) imaging finding. (B) Sagittal prebiopsy MR image with the same sequence reveals the tip of inserted obturator at the targeted lesion (arrow). (C) Axial MR image confirms the exact location of the tip (arrow). (D) Sagittal MR image obtained after vacuum biopsy shows air at anterior to biopsy site and lesion disappearance (arrow). (E) Overt hematoma (arrows) and echogenic air collection (arrowheads) are seen on ultrasound (US). US-guided tattooing for the vacuum-assisted biopsy site was done before the surgery. MR-guided vacuum-assisted biopsy revealed DCIS. Operation after the biopsy confirmed DCIS.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4197358&req=5

Figure 4: Images of a 49-year-old woman with diagnosed as ductal carcinoma in situ (DCIS) in the left breast. (A) Initial diagnostic contrast enhanced sagittal T1-weighted 3D turbo field-echo image shows segmental enhancing lesion without washout in the mid-outer region of the contralateral (right) breast (arrow). Mammograms and second-look ultrasound did not show clear relation with magnetic resonance (MR) imaging finding. (B) Sagittal prebiopsy MR image with the same sequence reveals the tip of inserted obturator at the targeted lesion (arrow). (C) Axial MR image confirms the exact location of the tip (arrow). (D) Sagittal MR image obtained after vacuum biopsy shows air at anterior to biopsy site and lesion disappearance (arrow). (E) Overt hematoma (arrows) and echogenic air collection (arrowheads) are seen on ultrasound (US). US-guided tattooing for the vacuum-assisted biopsy site was done before the surgery. MR-guided vacuum-assisted biopsy revealed DCIS. Operation after the biopsy confirmed DCIS.

Mentions: After MR-guided biopsy, 11 patients were operated upon including the MR-guided biopsy site. Because the cost of postbiopsy metallic markers is not covered in our country, we could not insert markers at the VAB site. Instead, we performed US-guided tattooing localization with 0.5 to 1 cc of a charcoal suspension for the biopsy site. In 10 of 11 cases, preoperative US-guided tattooing was successfully achieved for the overt VAB-related hematoma and echogenic air collection (Figure 4) and in one case, tattooing was performed at the approximate area because the biopsy site was not identified.


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)

Images of a 49-year-old woman with diagnosed as ductal carcinoma in situ (DCIS) in the left breast. (A) Initial diagnostic contrast enhanced sagittal T1-weighted 3D turbo field-echo image shows segmental enhancing lesion without washout in the mid-outer region of the contralateral (right) breast (arrow). Mammograms and second-look ultrasound did not show clear relation with magnetic resonance (MR) imaging finding. (B) Sagittal prebiopsy MR image with the same sequence reveals the tip of inserted obturator at the targeted lesion (arrow). (C) Axial MR image confirms the exact location of the tip (arrow). (D) Sagittal MR image obtained after vacuum biopsy shows air at anterior to biopsy site and lesion disappearance (arrow). (E) Overt hematoma (arrows) and echogenic air collection (arrowheads) are seen on ultrasound (US). US-guided tattooing for the vacuum-assisted biopsy site was done before the surgery. MR-guided vacuum-assisted biopsy revealed DCIS. Operation after the biopsy confirmed DCIS.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Images of a 49-year-old woman with diagnosed as ductal carcinoma in situ (DCIS) in the left breast. (A) Initial diagnostic contrast enhanced sagittal T1-weighted 3D turbo field-echo image shows segmental enhancing lesion without washout in the mid-outer region of the contralateral (right) breast (arrow). Mammograms and second-look ultrasound did not show clear relation with magnetic resonance (MR) imaging finding. (B) Sagittal prebiopsy MR image with the same sequence reveals the tip of inserted obturator at the targeted lesion (arrow). (C) Axial MR image confirms the exact location of the tip (arrow). (D) Sagittal MR image obtained after vacuum biopsy shows air at anterior to biopsy site and lesion disappearance (arrow). (E) Overt hematoma (arrows) and echogenic air collection (arrowheads) are seen on ultrasound (US). US-guided tattooing for the vacuum-assisted biopsy site was done before the surgery. MR-guided vacuum-assisted biopsy revealed DCIS. Operation after the biopsy confirmed DCIS.
Mentions: After MR-guided biopsy, 11 patients were operated upon including the MR-guided biopsy site. Because the cost of postbiopsy metallic markers is not covered in our country, we could not insert markers at the VAB site. Instead, we performed US-guided tattooing localization with 0.5 to 1 cc of a charcoal suspension for the biopsy site. In 10 of 11 cases, preoperative US-guided tattooing was successfully achieved for the overt VAB-related hematoma and echogenic air collection (Figure 4) and in one case, tattooing was performed at the approximate area because the biopsy site was not identified.

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