Vacuum-assisted biopsies under MR guidance: results of 72 procedures

Malhaire, Caroline; Khoury, C. El; Thibault, Fabienne; Athanasiou, A.; Petrow, Peter; Ollivier, L.; Tardivon, A.

doi:10.1007/s00330-009-1707-9

Cited by 74 publications

(44 citation statements)

References 33 publications

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“…Both frequency of high-risk lesions at MRgVABB and underestimation rates in our study are higher than previously reported in other studies (Table 4) evaluating outcomes of MR-guided breast biopsy [11,12,29,31,32]. This might be explained by the high pretest probability for breast cancer in our study population, which in addition to asymptomatic women undergoing screening MRI included a substantial proportion of diagnostic cases and patients with a personal history of breast carcinoma.…”

Section: Discussioncontrasting

confidence: 71%

High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted?

et al. 2010

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Objectives To evaluate the frequency of diagnosis of highrisk lesions at MRI-guided vacuum-assisted breast biopsy (MRgVABB) and to determine whether underestimation may be predicted. Methods Retrospective review of the medical records of 161 patients who underwent MRgVABB was performed. The underestimation rate was defined as an upgrade of a high-risk lesion at MRgVABB to malignancy at surgery. Clinical data, MRI features of the biopsied lesions, and histological diagnosis of cases with and those without underestimation were compared. Results Of 161 MRgVABB, histology revealed 31 (19%) high-risk lesions. Of 26 excised high-risk lesions, 13 (50%) were upgraded to malignancy. The underestimation rates of lobular neoplasia, atypical apocrine metaplasia, atypical ductal hyperplasia, and flat epithelial atypia were 50%

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Section: Discussioncontrasting

confidence: 71%

High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted?

et al. 2010

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“…The mean duration of vacuum assisted biopsy was reported as 65 min by Malhaire et al (26), and as 35 min by Tozaki et al (24). The mean duration of vacuum assisted biopsy was determined as 38 min (24-69 min) in our study, which was in concordance with previous studies.…”

Section: Discussionsupporting

confidence: 91%

Magnetic Resonance Imaging Guided Vacuum Assisted and Core Needle Biopsies

et al. 2016

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“…Current modern technological advances such as contrastenhanced MRI and vacuum core biopsy could potentially assist in providing a more accurate diagnosis of both extent of disease and presence of invasion in a significant proportion of cases, 29,30 particularly in cases of ER negative DCIS since our study suggests that underestimation of disease extent might be related to ER status. High-grade DCIS may be focally uncalcified, leading to underestimation of disease extent and an increased probability of the requirement for more than one therapeutic operation.…”

Section: Discussionmentioning

confidence: 77%

The influence of clinicopathological features on the predictive accuracy of conventional breast imaging in determining the extent of screen-detected high-grade pure ductal carcinoma in situ

Hayward

Oeppen

Grima

et al. 2011

annals

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Since the introduction of mammographic breast screening there has been a significant increase in the rate of detection of ductal carcinoma in situ (DCIS) without an invasive component (pure DCIS). This now comprises approximately 20% of all screen-detected breast malignancies in the uK. 1 DCIS may progress to invasive breast cancer. Apparently, pure DCIS frequently coexists with concurrent invasive breast cancer, which in cases of widespread high-grade DCIS is found unexpectedly on final histology following surgery in up to 10-25% of cases and necessitates additional staging of the axilla if axillary surgery is not performed. 2Screening mammography is very sensitive at detecting calcified high-grade DCIS. Approximately 80-90% of DCIS lesions are calcified, 3,4 which enables accurate prediction of disease extent. This is a major determinant of the suitability to treatment by wide local excision (WLE) and therefore breast conservation. It is recognised, however, that the distribution of calcification seen mammographically as well as on specimen radiographs is not always representative of the full extent of disease, leading to an underestimation of extent, both preoperatively and in intraoperative specimen radiographs.5 For example, DCIS is often found at or within a few millimetres of the initial excision margins. Re-excision procedures are often required as DCIS present at the surgical margin leads to a greater incidence of local recurrence. [6][7][8] Annual returns to the NHS Breast Screening Programme (NHSBSP) indicate that our re-excision rates for all pure screen-detected DCIS were 23% between 2008 and 2009. This figure is within normal limits for a large breast screening unit and is given as an example. As an NHSBSP centre, our unit is audited on a yearly basis against national standards. These audits confirmed that the overall rates of reexcision for DCIS historically over the period of this study were also within acceptable levels. However, we suspected from anecdotal evidence that the re-excision rates for pure The extent of calcified ductal carcinoma in situ (DCIS) detected by screening mammography is a determinant for treatment with breast conserving surgery (BCS). However, DCIS may be uncalcified and almost a quarter of patients with DCIS treated initially by BCS either require a second operation or are found to have unexpected invasive disease following surgery. Identification of these cases might guide selective implementation of additional diagnostic procedures. METHODS A retrospective review of patients with a preoperative diagnosis of pure high-grade DCIS at the Southampton and Salisbury Breast Screening Unit over a ten-year period was carried out. Mammograms were reviewed independently by a consultant radiologist and additional factors including the Breast Imaging Reporting and Data System (BI-RADS

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Vacuum-assisted biopsies under MR guidance: results of 72 procedures

Abstract: MRI-guided VAB represents an accurate tool for the histological diagnosis of lesions visible only at MRI.

Cited by 74 publications

References 33 publications

High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted?

High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted?

Magnetic Resonance Imaging Guided Vacuum Assisted and Core Needle Biopsies

The influence of clinicopathological features on the predictive accuracy of conventional breast imaging in determining the extent of screen-detected high-grade pure ductal carcinoma in situ

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