MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques

Abstract

ObjectivesTo analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB.MethodsWe performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided.ResultsMRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guided and ultrasound-guided VAB were 98.4 % (548/557), 99.1 % (5,904/5,960) and 99.6 % (2,585/2,596), respectively. There were no significant differences (P = 0.12) between the MRI-guided and the stereotactically guided procedures. The technical success rate for ultrasound-guided VAB was significantly higher than that for MRI-guided VAB (P < 0.001). There were no complications using MRI-guided VAB requiring open surgery. The malignancy diagnosis rate for MRI-guided VAB was similar to that for stereotactically guided VAB (P = 0.35).ConclusionMRI-guided VAB is a safe and accurate procedure that provides insight into clinical breast findings.Key points• Three vacuum-assisted breast biopsy (VAB) procedures were compared.• Technical success rates were high for all three VAB procedures.• Medical complications were relatively low using all three VAB procedures.• The use of MRI-guided vacuum-assisted breast biopsy is growing.

MRI‐guided breast interventions

“…High‐risk lesions identified with MRI‐guided biopsy have underestimation rates of ∼19–50% . This rate is slightly higher than what is reported for stereotactic biopsies and may reflect the underlying high‐risk patient population and the inability to confirm adequate sampling of the target (eg, most stereotactic biopsies are for suspicious calcifications, the presence of which can be confirmed radiographically by taking radiographs of the cores). Surgical upgrade rates to malignancy are reported as high as 38%, with atypical ductal hyperplasia (ADH) identified on MRI‐guided biopsy (Table ).…”

Technical Note: Development of a combined molecular breast imaging/ultrasound system for diagnostic evaluation of MBI‐detected lesions

“…Despite its diagnostic utility, dependence on MR-guided biopsy to resolve MBI-detected lesions is not a tenable solution as it is not available in all institutions and is considerably more expensive, technically challenging, and time-consuming than ultrasound-guided biopsy methods. 14,15 In addition, some patients have contraindications to MR imaging such as implantable devices or an inability to tolerate the procedure. Hence, integration of a biopsy system using a lateral approach, such as that reported by Ma et al, 16 into a combined MBI/US system may be a worthwhile goal.…”

Clinical Application and Feasibility of MRI-Guided Breast Biopsy of Breast Minimal Lesions in Chinese Population

“…Although MRI has a high reported sensitivity for detecting breast cancer of 94-100%, its specificity is relatively low, ranging from 37 to 72% (4, 5); thus, biopsy is often required to establish a diagnosis (6). These techniques have been performed successfully and evolved into routine methods in Caucasian populations after ∼20 years of clinical use (7)(8)(9)(10). However, there are inadequate studies in Asian countries about MRI-guided biopsy (1,11,12), though MRI-guided biopsy is more valuable in China compared with ultrasound-guided biopsy or mammogram-guided biopsy because there are more dense areas in glandular tissue of Asian women.…”