Stereotactic biopsy with contrast-enhanced mammography: the initial Australian experience

Area of Science:

• Radiology
• Oncology
• Breast Imaging

Background:

• Contrast-enhanced mammography (CEM) and MRI can identify contrast-only lesions (COLs) not visible on conventional breast imaging.
• Historically, MRI was the primary method for biopsying these lesions.
• This study details the initial Australian experience with CEM-guided biopsy (CEMBx).

Purpose of the Study:

• To evaluate the feasibility and outcomes of CEM-guided biopsy (CEMBx) for contrast-only lesions (COLs).
• To present the first Australian experience and lessons learned from CEMBx procedures.

Main Methods:

• A prospective audit of 15 consecutive patients undergoing CEMBx for COLs.
• Data collected included indications for contrast imaging, patient/lesion characteristics, procedural details, radiation dose, and pathology.
• Biopsies were performed using standard compression and a horizontal approach.

Main Results:

• The study included 15 women aged 37-81 years.
• Indications varied, including cancer staging (n=9) and problem-solving (n=3).
• All lesions were successfully sampled with marker clip insertion; 87.5% used cranio-caudal compression.
• Histopathology revealed malignancy in 7 patients, benign findings in 8, and one borderline breast lesion.
• Minor complications included hematomas (n=3) and clip displacement (n=3), with high patient satisfaction.

Conclusions:

• CEM-guided biopsy (CEMBx) is a rapid, secure, and dependable option for sampling contrast-only lesions (COLs).
• It serves as a viable alternative to MRI-guided biopsy for these challenging breast lesions.