MR imaging-guided 10-gauge vacuum-assisted breast biopsy: histological characterisation

Purpose The aim of this study was to evaluate a handheld vacuum-assisted device for magnetic resonance imaging (MRI)-guided breast biopsy. Materials and methods In 47 patients, a total of 47 suspicious breast lesions (mean maximum diameter 9 mm) seen with MRI (no suspicious changes on breast ultraso...

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Bibliographic Details
Published in:Radiologia medica 2008-09, Vol.113 (6), p.830-840
Main Authors: Perretta, T., Pistolese, C. A., Bolacchi, F., Cossu, E., Fiaschetti, V., Simonetti, G.
Format: Article
Language:eng ; ita
Subjects:
Adult
Aged
Biopsy, Needle - instrumentation
Biopsy, Needle - methods
Breast - pathology
Breast Diseases - pathology
Breast Neoplasms - pathology
Breast Radiology/Senologia
Contrast Media
Diagnosis, Differential
Diagnostic Radiology
Female
Follow-Up Studies
Gadolinium DTPA
Humans
Imaging
Interventional Radiology
Magnetic Resonance Imaging - instrumentation
Magnetic Resonance Imaging - methods
Medicine
Medicine & Public Health
Middle Aged
Neuroradiology
Radiology
Time Factors
Ultrasound
Vacuum
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Summary:Purpose The aim of this study was to evaluate a handheld vacuum-assisted device for magnetic resonance imaging (MRI)-guided breast biopsy. Materials and methods In 47 patients, a total of 47 suspicious breast lesions (mean maximum diameter 9 mm) seen with MRI (no suspicious changes on breast ultrasound or mammography) were sampled using a 10-gauge vacuum-assisted breast biopsy (VAB) device under MRI guidance. Histology of biopsy specimens was compared with final histology after surgery or with follow-up in benign lesions. Results Technical success was achieved in all biopsies. Histological results from VAB revealed malignancy in 15 lesions (32%), atypical ductal hyperplasia in four lesions (8%) and benign findings in 28 lesions (60%). One of four lesions with atypical ductal hyperplasia was upgraded to ductal carcinoma in situ after surgery. One of seven lesions showing ductal carcinoma was upgraded to invasive carcinoma after surgery. Two lesions diagnosed as infiltrating carcinoma by VAB were not validated at excisional biopsy due to complete removal of the lesion during the procedure. During the follow-up (mean 18 months) of histologically benign lesions, we observed no cases of breast cancer development. Because of morphological changes on follow-up MRI scans, two lesions underwent surgical excision, which confirmed their benign nature. Besides minor complications (massive bleeding, n=1) requiring no further therapeutic intervention, no complications occurred. Conclusions MRI-guided biopsy of breast lesions using a handheld vacuum-assisted device is a safe and effective method for the workup of suspicious lesions seen on breast MRI alone.
ISSN:0033-8362
1826-6983
DOI:10.1007/s11547-008-0289-y