MR-guided vacuum-assisted breast biopsy of MRI-only lesions: a single center experience.
PURPOSE
The purpose of this study was to compare three different biopsy devices on false-negative and underestimation rates in MR-guided, vacuum-assisted breast biopsy (VABB) of MRI-only lesions.


METHODS
This retrospective, single-center study was IRB-approved. Informed consent was waived. 467 consecutive patients underwent 487 MR-guided VABB using three different 8-10-gauge-VABB devices (Atec-9-gauge,A; Mammotome-8-gauge,M; Vacora-10-gauge,V). VABB data (lesion-type, size, biopsy device, histopathology) were compared to final diagnosis (surgery, n = 210 and follow-up, n = 277). Chi-square, and Kruskal-Wallis tests were applied. P values < 0.05 were considered significant.


RESULTS
Final diagnosis was malignant in 104 (21.4 %), high risk in 64 (13.1 %) and benign in 319 (65.5 %) cases. Eleven of 328 (3.4 %) benign-rated lesions were false-negative (1/95, 1.1 %, A; 2/73, 2.7 %, M; 8/160 5.0 % V; P = 0.095). Eleven high-risk (11/77, 14.3 %) lesions proved to be malignant (3/26, 11.5 % A; 4/12, 33.3 % M; 4/39, 10.3 % V; P = 0.228). Five of 34 (14.7 %) DCIS were upgraded to invasive cancer (2/15, 13.3 %, A; 1/6, 16.6 % M; 2/13, 15.3 %, V; P = 0.977). Lesion size (P = 0.05) and type (mass vs. non-mass, P = 0.107) did not differ significantly.


CONCLUSION
MR-guided VABB is an accurate method for diagnosis of MRI-only lesions. No significant differences on false-negative and underestimation rates were observed between three different biopsy devices.


KEY POINTS
• MR-guided VABB is an accurate procedure for the diagnosis of MRI-only lesions. • Similar false-negative and underestimation rates allow all three different MR-guided VABB devices for clinical application. • High-risk lesions should undergo surgery due to a substantial underestimation rate. • Agreement between MR-guided VABB and final diagnosis (benign/malignant) was 95.5% (465/487).
['Spick|Claudio|C|', 'Schernthaner|Melanie|M|', 'Pinker|Katja|K|', 'Kapetas|Panagiotis|P|', 'Bernathova|Maria|M|', 'Polanec|Stephan H|SH|', 'Bickel|Hubert|H|', 'Wengert|Georg J|GJ|', 'Rudas|Margaretha|M|', 'Helbich|Thomas H|TH|', 'Baltzer|Pascal A|PA|']
D000328:Adult D000368:Aged D001707:Biopsy, Needle D001940:Breast D001943:Breast Neoplasms D018270:Carcinoma, Ductal, Breast D005260:Female D006801:Humans D061705:Image-Guided Biopsy D008279:Magnetic Resonance Imaging D008875:Middle Aged D012189:Retrospective Studies D014618:Vacuum
MRI-only lesions Breast cancer MR imaging MR-guided biopsy Vacuum assisted breast biopsy