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

Gaiane M. Rauch, Basak E. Dogan, Taletha B. Smith, Ping Liu, Wei T. Yang

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)292-299
Number of pages8
JournalAmerican Journal of Roentgenology
Volume198
Issue number2
DOIs
StatePublished - Feb 2012

Keywords

  • Breast biopsy
  • Breast lesions
  • MRI-guided biopsy
  • Vacuum-assisted biopsy
  • Women's imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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