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AJR Am J Roentgenol. 2012 Feb;198(2):292-9. doi: 10.2214/AJR.11.7594.

Outcome analysis of 9-gauge MRI-guided vacuum-assisted core needle breast biopsies.

Author information

1
Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030, USA. gmrauch@mdanderson.org

Abstract

OBJECTIVE:

The purpose of this article is to correlate 9-gauge MRI-guided vacuum-assisted breast biopsy with surgical histologic findings to determine the upgrade rate and to correlate the frequency of MRI-guided vacuum-assisted breast biopsy cancer diagnosis with breast MRI indications and enhancement characteristics of targeted lesions.

MATERIALS AND METHODS:

A database search was performed of all MRI-guided vacuum-assisted breast biopsies performed from January 1, 2005, to September 31, 2010. The breast MRI indications, history, age, risk factors, lesion size, enhancement characteristics, and pathologic diagnoses at MRI-guided vacuum-assisted breast biopsy and at surgery were documented. Fisher exact test and analysis of variance were used for statistical analysis.

RESULTS:

A total of 218 lesions underwent MRI-guided vacuum-assisted breast biopsy in 197 women (mean age, 52 years; range, 28-76 years), of which 85 (39%) had surgical correlation. Of the 218 lesions, 48 (22%) were malignant, 133 (61%) were benign, and 37 (17%) were high risk according to MRI-guided vacuum-assisted breast biopsy. Ten of 85 lesions (12%) were upgraded to malignancy at surgery, with a final malignancy rate of 25%. The frequency of malignancy was significantly higher in patients presenting for diagnostic (50/177 [28%]) versus screening (4/41 [10%]; p < 0.05) evaluation, patients with ipsilateral cancer (22/49 [45%]; p < 0.001), and lesions with washout kinetics (34/103 [33%]; p < 0.05) and was relatively higher in lesions with nonmasslike enhancement (26/76 [34%]; p = 0.07), which represented ductal carcinoma in situ in the majority of cases (17/26 [65%]; p < 0.005).

CONCLUSION:

Patients with ipsilateral cancer who have additional suspicious lesions identified on MRI require careful evaluation and biopsy to exclude additional sites of cancer that may impact surgical management.

PMID:
22268171
PMCID:
PMC4111151
DOI:
10.2214/AJR.11.7594
[Indexed for MEDLINE]
Free PMC Article
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