Do benign-concordant breast MRI biopsy results require short interval follow-up imaging? Report of longitudinal study and review of the literature

Pinkney, David M.; Chikarmane, Sona A.; Giess, Catherine S.

doi:10.1016/j.clinimag.2019.05.007

Cited by 10 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A VABB diagnosis of a benign lesion is considered reliable when there is agreement between radiological suspicion and histological results [ 20 , 21 ]. In the literature, it is recommended to conduct an MRI examination at 6 months after a benign concordant VABB [ 22 , 23 ]. In contrast, based on our experience, we consider the biopsy result to be adequate without the need for a subsequent MRI 6-month follow-up, depending on factors such as the initial radiological suspicion, imaging findings before and after the biopsy, and concordant histological results.…”

Section: Discussionmentioning

confidence: 99%

“…In the Third International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) [ 25 ], the majority of panelists suggest open excision for ADH and PT, while for other B3 lesions (RS, FEA, PL, LIN) VAE is considered an alternative to open excision. High-risk lesions that were diagnosed by MRI VABB, and in which a subsequent diagnosis of invasive cancer or DCIS lesion was made at surgical excision were considered underestimates [ 23 ]. In our study, no upgrades to carcinoma were observed in the MRI-guided biopsies for B3 lesions without atypia (B3a).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term outcome of 9G MRI-guided vacuum-assisted breast biopsy: results of 293 single-center procedures and underestimation rate of high-risk lesions over 12 years

Rescinito,

Brunetti,

Garlaschi

et al. 2024

Radiol med

View full text Add to dashboard Cite

Purpose Breast magnetic resonance imaging (MRI) can detect some malignant lesions that are not visible on mammography (MX) or ultrasound (US). If a targeted, second-look fails, MRI-guided breast biopsy is the only available tool to obtain a tissue sample and pathological proof of these “MRI-only lesions”. The aim of this study is to report the performance and underestimation rate of 9G MRI-guided vacuum-assisted breast biopsy (VABB) over 12 years at a single center. Material and methods All 9G MRI-VABB procedures performed from January 2010 to December 2021 were retrospectively reviewed. Two MRI scanners (1.5 T and 3 T) were used with the same image resolution and contrast media. All suspicious lesions detected only by breast MRI underwent biopsy. Reference standard was histological diagnosis or at least 1-year negative follow-up. All malignant and atypical lesions underwent surgery, which was used as the reference standard. Results A total of 293 biopsies were retrospectively reviewed. Histopathological VABB results revealed 142/293 (48.4%) benign lesions, 77/293 (26.2%) high-risk lesions, and 74/293 (25.2%) malignant lesions. No significant complications were observed. Surgical pathology results allowed for the reclassification of n = 7/48 B3b lesions: n = 4 were ductal carcinoma in situ, while n = 3 presented invasive features at surgical histology (2 IDC; 1 ILC). B3b underestimation occurred overall in 14.6% of B3 cases. Breast follow-up was achieved for all benign VABB results, and only one false-negative case was observed. Conclusion Our results confirm that 1.5 T and 3 T MRI-guided VABB is an accurate and safe procedure for histopathologic final diagnosis of MRI-only lesions. Critical issues remain the potential high-risk underestimation rate of B3b VABB results and management of follow-up of benign lesions.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long-term outcome of 9G MRI-guided vacuum-assisted breast biopsy: results of 293 single-center procedures and underestimation rate of high-risk lesions over 12 years

Rescinito,

Brunetti,

Garlaschi

et al. 2024

Radiol med

View full text Add to dashboard Cite

show abstract

“…Moreover, the lesion nonvisualization rate at procedural CEM (4.5%) was also already lower than the 8-13% estimates reported for MRIguided biopsy [10]. Larger series are however needed to classify nonvisualization causes and to ascertain how background parenchymal enhancement influences CEM-guided biopsy, but also to evaluate its associated radiation dose and the potential role of short-term follow-up for imaging-concordant benign biopsy results-which remains a controversial aspect of MRI-guided biopsy [10,14]. Mirroring the efforts directed at developing non-contrast MRI-guided biopsy based on diffusion-weighted imaging [15], specific studies will also allow to explore the feasibility of a non-contrast version of CEM-guided biopsy, based on artificial intelligence-driven generation of synthetic recombined CEM images [16].…”

mentioning

confidence: 89%

Contrast-enhanced mammography-guided biopsy: why, when, and where we need it

Schiaffino

Cozzi

2022

Eur Radiol

View full text Add to dashboard Cite

The use of CEM-guided biopsy is spreading after initial experiences in a few pilot centers.• CEM-guided biopsy has the potential to ensure fast, low-cost, and effective tissue sampling of MRI-detected and CEM-detected lesions that do not have a corresponding finding at morphological imaging. • The need and utility of CEM-guided biopsy are warranted by the impending expansion of morpho-functional imaging towards breast cancer screening for women with extremely dense breasts."The tools which would teach men their own use would be beyond price." Plato -The Republic, II.374D

show abstract

“…However, dynamic contrast-enhanced MRI (DCE-MRI) has several significant limitations that make it suboptimal for many diagnostic indications, including a high false positive rate, high cost, the need for IV cannulation, and potential side effects of the GBCA [ 6 , 10 ]. Up to one-third of women undergoing DCE-MRI may be called back for follow-up or biopsy, and up to 40% of the resultant breast biopsies are benign [ 11 , 12 ]. Consequently, similar to the situation with MG and US, DCE-MRI scans frequently lead to additional biopsies for lesions that appear suspicious but are subsequently evaluated as benign [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Diffusion Tensor Imaging for Decreasing Biopsy Rates in Breast Imaging: Interim Analysis of a Prospective Study

Ecanow

Hack

et al. 2023

Diagnostics

View full text Add to dashboard Cite

Because of the limited specificity of diagnostic imaging, many breast lesions referred for biopsy turn out to be benign. The objective of this study was to evaluate whether diffusion tensor MRI (DTI) parametric maps can be used to safely avoid biopsy of breast lesions. Individuals referred for breast biopsy based on mammogram (MG), ultrasound (US), and/or contrast enhanced (CE)-MRI were recruited. Scans consisting of T2-weighted and DTI sequences were performed. Multiple DTI-derived parametric color maps were evaluated semi-quantitatively to characterize lesions as “definitely benign,” “not definitely benign,” or “suspicious.” All patients subsequently underwent biopsy. In this moderately-sized prospective study, 21 out of 47 pathologically proven benign lesions were characterized by both readers as “definitely benign,” which would have precluded the need for biopsy. Biopsy was recommended for 11 out of 13 cancers that were characterized as “suspicious.” In the remaining two cancers and 26 of 47 benign lesions, the scans were characterized as “not definitely benign” and hence required biopsy. The main causes for “not definitely benign” scans were small lesion sizes and noise. The results suggest that in appropriately selected patients, DTI may be used to safely reduce the number of unnecessary breast biopsies.

show abstract

Do benign-concordant breast MRI biopsy results require short interval follow-up imaging? Report of longitudinal study and review of the literature

Cited by 10 publications

References 10 publications

Long-term outcome of 9G MRI-guided vacuum-assisted breast biopsy: results of 293 single-center procedures and underestimation rate of high-risk lesions over 12 years

Long-term outcome of 9G MRI-guided vacuum-assisted breast biopsy: results of 293 single-center procedures and underestimation rate of high-risk lesions over 12 years

Contrast-enhanced mammography-guided biopsy: why, when, and where we need it

Feasibility of Diffusion Tensor Imaging for Decreasing Biopsy Rates in Breast Imaging: Interim Analysis of a Prospective Study

Contact Info

Product

Resources

About