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MR-Guided vacuum biopsy of 206 contrast-enhancing breast lesions
C Perlet1, P Schneider, B Amaya
1Institut für Klinische Radiologie, Klinikum der Universität Grosshadern, München, Germany.
Purpose:
To determine the accuracy and clinical use of MR-guided vacuum biopsy (VB) of enhancing breast lesions.
Material And Methods:
254 lesions were referred to MR-guided vacuum-assisted breast biopsy. In 43 (16 %) patients the indication was dropped because the lesions could not be identified at the time VB was scheduled. This was due to hormonal influences (n = 37), to too strong compression (n = 3) or to misinterpretation of the initial diagnostic MRI (n = 3). In 5 cases (2 %) VB was not performed due to obesity (n = 2); problems of access (n = 2) or a defect of the MR-unit (n = 1). VB was performed on altogether 206 lesions. In 4 cases (2 %) VB was unsuccessful. This was immediately realized on the post-interventional images. Thus a false negative diagnosis was avoided. Verification included excision of the cavity in cases with proven malignancy or atypical ductal hyperplasia (ADH) and (for benign lesions) retrospective correlation of VB-histology with pre-and postinterventional MRI and subsequent follow-up.
Results:
51/202 successful biopsies proved malignancy. In 7 cases ADH and in 144 cases a benign lesion was diagnosed. One DCIS was underestimated as ADH. All other benign or malignant diagnoses proved to be correct.
Conclusion:
MR-guided VB allows reliable histological work-up of contrast-enhancing small lesions which are not visible by any other modality.