Skip to main content

Advertisement

SpringerLink
Log in

Long-term MRI-guided vacuum-assisted breast biopsy results of 600 single-center procedures

  • Breast
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

The objective of this study is to report on the performance of the MRI-guided VABB in our center and to look at the long-term outcome of biopsies with benign histology over a period of 19 years.

Methods

In a single-center retrospective review study, data of 600 VABB procedures performed between September 1999 and March 2017 were evaluated. We collected patient demographics, histopathological diagnosis at MRI-VABB, and basic lesion characteristics (size, location). Data from the Belgian Cancer Registry was cross-referenced with our database to find out which patients with benign MRI-VABB results developed a malignant lesion over time.

Results

These 600 VABB procedures were performed in 558 women with a mean patient age of 51.8 years (range 18–82 years). Our technical success rate was 99.3%. We found 27.67% B5 lesions, 9.82% B3 lesions, and 0.17% B4 lesions. Of 362 benign MRI-guided VABBs, follow-up data was available for a mean follow-up period of 7.6 years (0.8–18.3). Only one (0.3%) biopsy was a false negative lesion after MRI-guided VABB during follow-up. Short-term FU-MRI provided no increase in detection rate.

Conclusion

The accuracy of MRI-guided VABB is high with a very low false negative rate of 0.3% on long-term follow-up. The value of short-term FU-MRI for every case after MRI-guided VABB may be questioned.

Key Points

• MRI-guided vacuum-assisted breast biopsies yield a large portion of clinically relevant lesions (9.82% B3, 0.17% B4, and 27.67% B5 lesions).

• The false negative biopsy rate of MRI-guided VABB in this study with a mean follow-up time of 7.6 years was only 0.3%.

• Performing a short-term follow-up MRI after a benign MRI-guided VABB concordant to the MRI appearance may be questioned.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Abbreviations

BI-RADS:

Breast imaging-reporting and data system

CNB:

Core needle biopsy

DCIS:

Ductal carcinoma in situ

EUSOMA:

European Society of Breast Cancer Specialists

FU-MRI:

Follow-up MRI

IDA:

Invasive ductal adenocarcinoma

ILA:

Invasive lobular adenocarcinoma

LCIS:

Lobular carcinoma in situ

LIQ:

Lower inner quadrant

LOQ:

Lower outer quadrant

MX:

Mammography

NHSBSP:

National Health Service Breast Cancer Screening Program

UIQ:

Upper inner quadrant

UOQ:

Upper outer quadrant

US:

Ultrasound

VABB:

Vacuum-assisted biopsy of the breast

References

  1. Bennani-Baiti B, Bennani-Baiti N, Baltzer PA (2016) Diagnostic performance of breast magnetic resonance imaging in non-calcified equivocal breast findings: results from a systematic review and meta-analysis. PLoS One 11:99–100

    Google Scholar 

  2. Bick U, Trimboli RM, Athanasiou A et al (2020) Image-guided breast biopsy and localisation: recommendations for information to women and referring physicians by the European Society of Breast Imaging. Insights Imaging 11. https://doi.org/10.1186/s13244-019-0803-x

  3. Morris EA, Comstock CE, Lee CH et al (2013) ACR BI-RADS Magnetic Resonance Imaging. In: D'Orsi CJ, Sickles EA, Mendelson EB et al. ACR BIRADS Atlas, Breast Imaging Reporting and Data System. Reston, VA: Amercian College of Radiology

  4. Wildiers H, Stordeur S, Vlayen J et al (2013) Breast cancer in women: diagnosis, treatment and follow-up. In: KCE Rep. 143 – 3rd Ed. Brussels, Belgium, Belgian Health Care Knowledge Centre (KCE)

  5. Spick C, Schernthaner M, Pinker K et al (2016) MR-guided vacuum-assisted breast biopsy of MRI-only lesions: a single center experience. Eur Radiol 26:3908–3916. https://doi.org/10.1007/s00330-016-4267-9

    Article  PubMed  PubMed Central  Google Scholar 

  6. Imschweiler T, Haueisen H, Kampmann G et al (2014) MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques. Eur Radiol 24:128–135. https://doi.org/10.1007/s00330-013-2989-5

    Article  PubMed  Google Scholar 

  7. Li J, Dershaw DD, Lee CH, Kaplan J, Morris EA (2009) MRI follow-up after concordant, histologically benign diagnosis of breast lesions sampled by MRI-guided biopsy. AJR Am J Roentgenol 193:850–855. https://doi.org/10.2214/AJR.08.2226

  8. Rauch GM, Dogan BE, Smith TB, Liu P, Yang WT (2012) Outcome analysis of 9-gauge MRI-guided vacuum-assisted core needle breast biopsies. AJR Am J Roentgenol 198:292–299. https://doi.org/10.2214/AJR.11.7594

  9. Perlet C, Heywang-Kobrunner SH, Heinig A et al (2006) Magnetic resonance-guided, vacuum-assisted breast biopsy: results from a European multicenter study of 538 lesions. Cancer 106:982–990. https://doi.org/10.1002/cncr.21720

    Article  PubMed  Google Scholar 

  10. Malhaire C, El Khoury C, Thibault F et al (2010) Vacuum-assisted biopsies under MR guidance: results of 72 procedures. Eur Radiol 20:1554–1562. https://doi.org/10.1007/s00330-009-1707-9

    Article  CAS  PubMed  Google Scholar 

  11. Meeuwis C, Veltman J, Van Hall HN et al (2012) MR-guided breast biopsy at 3T: diagnostic yield of large core needle biopsy compared with vacuum-assisted biopsy. Eur Radiol 22:341–349. https://doi.org/10.1007/s00330-011-2272-6

    Article  PubMed  Google Scholar 

  12. Pinkney D, Chikarmane S, Giess C (2019) Do benign-concordant breast MRI biopsy results require short interval follow-up imaging? Report of longitudinal study and review of the literature. Clin Imaging 57:50–55. https://doi.org/10.1016/j.clinimag.2019.05.007

    Article  PubMed  Google Scholar 

  13. Hayward J, Ray K, Wisner D, Joe B (2016) Follow-up outcomes after benign concordant MRI-guided breast biopsy. Clin Imaging 40:1034–1039. https://doi.org/10.1016/j.clinimag.2016.06.005

    Article  PubMed  Google Scholar 

  14. Huang M, Speer M, Dogan B et al (2017) Imaging-concordant benign MRI-guided vacuum-assisted breast biopsy may not warrant MRI follow-up. AJR Am J Roentgenol 208:916–922. https://doi.org/10.2214/AJR.16.16576

    Article  PubMed  Google Scholar 

  15. Shaylor SD, Heller SL, Melsaether AN et al (2014) Short interval follow-up after a benign concordant MR-guided vacuum assisted breast biopsy - is it worthwhile? Eur Radiol 24:1176–1185. https://doi.org/10.1007/s00330-014-3125-x

    Article  PubMed  Google Scholar 

  16. Wallis M, Tarvidon A, Helbich T, Schreer I (2007) Guidelines from the European Society of Breast Imaging for diagnostic interventional breast procedures. Eur Radiol 17:581–588. https://doi.org/10.1007/s00330-006-0408-x

    Article  PubMed  Google Scholar 

  17. Heywang-Köbrunner SH, Bick U, Bradley WG et al (2001) International investigation of breast MRI: results of a multicentre study ( 11 sites ) concerning diagnostic parameters for contrast-enhanced MRI based on 519 histopathologically correlated lesions. Eur Radiol 11:531–546

    Article  Google Scholar 

  18. Perlet C, Heinig A, Prat X et al (2002) Multicenter study for the evaluation of a dedicated biopsy device for MR-guided vacuum biopsy of the breast. Eur Radiol 12:1463–1470. https://doi.org/10.1007/s00330-002-1376-4

    Article  CAS  PubMed  Google Scholar 

  19. Hefler L, Casselman J, Amaya B et al (2003) Follow-up of breast lesions detected by MRI not biopsied due to absent enhancement of contrast medium. Eur Radiol 13:344–346. https://doi.org/10.1007/s00330-002-1713-7

    Article  CAS  PubMed  Google Scholar 

  20. Delille JP, Slanetz PJ, Yeh ED, Kopans DB, Garrido L (2005) Physiologic changes in breast magnetic resonance imaging during the menstrual cycle: perfusion imaging, signal enhancement, and influence of the T1 relaxation time of breast tissue. Breast J 11:236–241. https://doi.org/10.1111/j.1075-122X.2005.21499.x

  21. Krug B, Hellmich M, Ulhaas A et al (2016) Vacuum-assisted breast biopsies (VAB) carried out on an open 1.0T MR imager: influence of patient and target characteristics on the procedural and clinical results. Eur J Radiol 85:1157–1166. https://doi.org/10.1016/j.ejrad.2016.02.030

  22. Merle N, Despeyroux S, Lombry Y, et al (2011) HTA Summary report: MRI-guided vacuum-assisted breast biopsy (VABB). Available via https://www.has-sante.fr/upload/docs/application/pdf/2012-02/hta_summary_report_mriguided_vacuum-assisted_breast_biopsy__vabb_.pdf

  23. Shin S, Schneider HB, Cole FJ, Laronga C (2006) Follow-up recommendations for benign breast biopsies. Breast J 12:413–417. https://doi.org/10.1111/j.1075-122X.2006.00302.x

    Article  PubMed  Google Scholar 

  24. Mann RM, Balleyguier C, Baltzer PA et al (2015) Breast MRI: EUSOBI recommendations for women’ s information. Eur Radiol 25:3669–3678. https://doi.org/10.1007/s00330-015-3807-z

    Article  PubMed  PubMed Central  Google Scholar 

  25. Taskin F, Soyder A, Tanyeri A, Öztürk VS, Ünsal A (2017) Lesion characteristics, histopathologic results, and follow-up of breast lesions after MRI-guided biopsy. Diagn Interv Radiol 23:333–338. https://doi.org/10.5152/dir.2017.17004

  26. Ferré R, Ianculescu V, Ciolovan L et al (2016) Diagnostic performance of MR-guided vacuum-assisted breast biopsy: 8 years of experience. Breast J 22:83–89. https://doi.org/10.1111/tbj.12519

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We want to thank the Belgian Cancer Registry for providing us the long-term follow-up data of the patients who underwent a MRI-guided VABB in our hospital and hence making this study possible.

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Department of Radiology, AZ Sint Jan Brugge-Oostende AV, Campus Sint Jan, Ruddershove 10, 8000, Bruges, Belgium

    J. Lambert, K. Gieraerts & J. W. Casselman

  2. Department of Radiology, University Hospitals Leuven, Leuven, Belgium

    J. Lambert & Ch. Van Ongeval

  3. Department of Pathology, University Hospitals Leuven, Leuven, Belgium

    T. Steelandt

  4. Reference Center Mammography, Munich, Germany

    S. H. Heywang-Köbrunner

  5. Department of Pathology, AZ Sint Jan Brugge-Oostende AV, Bruges, Belgium

    I. Van Den Berghe

  6. Department of Radiology, University Ghent, Ghent, Belgium

    J. W. Casselman

Authors
  1. J. Lambert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Steelandt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. H. Heywang-Köbrunner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Gieraerts
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. I. Van Den Berghe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ch. Van Ongeval
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. W. Casselman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. W. Casselman.

Ethics declarations

Guarantor

The scientific guarantor of this publication is J.W. Casselman.

Conflict of interest

The authors of this manuscript declare relationships with the following companies:

J.W. Casselman provides presentations for Philips and receives clients for Philips. Also, he organizes workshops for Leica-Devicor Mammotome. None of the other authors have any conflict of interest.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

A minor subgroup of our study (52 patients) was already included in a prior multicenter study by Heywang-Köbrunner SH et al, Eur Radiol (2001) 11:531-546. Also, data of the VABB procedures of these 52 patients was used in the three following publications: Perlet et al, Eur Radiol. (2002) 12(6):1463–70; Hefler et al, Eur Radiol (2003) 13(2):344–6 and Perlet et al, Cancer (2006) 106(5):982–90. Our new dataset includes 507 additional patients for a total of 600 biopsies, now in a single-center setting, with a much more extensive follow-up available for analysis of the false negative rate.

Methodology

• retrospective

• observational

• performed at one institution

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lambert, J., Steelandt, T., Heywang-Köbrunner, S.H. et al. Long-term MRI-guided vacuum-assisted breast biopsy results of 600 single-center procedures. Eur Radiol 31, 4886–4897 (2021). https://doi.org/10.1007/s00330-020-07392-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-020-07392-6

Keywords

Search

Navigation