Imaging-concordant benign mriguided vacuum-assisted breast biopsy may not warrant MRI Follow-Up

Monica L. Huang, Megan Speer, Basak E. Dogan, Gaiane M. Rauch, Rosalind P. Candelaria, Beatriz E. Adrada, Kenneth R. Hess, Wei T. Yang

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

OBJECTIVE. The follow-up of breast lesions with imaging-concordant benign histopathology results on MRI-guided vacuum-assisted biopsy (VAB) is not currently standardized. We determined the false omission rate of breast MRI-guided VAB with benign histopathology (negative results) to assess whether breast MRI follow-up is needed. MATERIALS AND METHODS. The medical records of patients who underwent 9-gauge breast MRI-guided VAB during 2007-2012 were reviewed retrospectively. Lesions with imaging-concordant benign histopathology results from MRI-guided VAB and surgery or 2 years or more of imaging follow-up were included. The false omission rate (1 - negative predictive value; [number of false-negative results / number of negative results]) of MRI-guided VAB was calculated. RESULTS. One hundred sixty-nine lesions were included, and 135 had only imaging follow- up (mammography follow-up: range, 17-107 months [median, 52 months]; MRI followup: range, 5-95 months [median, 35 months]). Of the 135 lesions with only imaging follow-up, 48 had mammography only (range, 26-86 months; median, 52 months), and 87 had mammography (range, 17-107 months; median, 52 months) and MRI (range, 5-95 months; median, 35 months). Thirty-four lesions had surgical correlation, and there were no cases of imaging-surgical discordance. Four malignancies were later diagnosed in the same breast in which MRIguided VAB had been performed. One (0.6%) malignancy was invasive ductal carcinoma at 1 cm from the MRI-guided VAB site; it was mammographically detected 24 months after MRIguided VAB. The other three malignancies developed 4 cm or more from the site of MRIguided VAB: one ductal carcinoma in situ (DCIS) detected on mammography 12 months after MRI-guided VAB, one DCIS detected on MRI 24 months after MRI-guided VAB, and one Paget disease lesion detected at physical examination 32 months after MRI-guided VAB. CONCLUSION. Breast MRI-guided VAB has a low false omission rate. MRI follow-up of lesions with concordant benign MRI-guided VAB histopathology results may not be warranted.

Original languageEnglish (US)
Pages (from-to)916-922
Number of pages7
JournalAmerican Journal of Roentgenology
Volume208
Issue number4
DOIs
StatePublished - Apr 2017

Keywords

  • Benign
  • Breast
  • Imaging-concordant
  • MRI-guided
  • Vacuum-assisted breast biopsy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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