Advertisement

European Radiology

, Volume 26, Issue 8, pp 2510–2519 | Cite as

Breast MR biopsy: Pathological and radiological correlation

  • Chloé Dratwa
  • Aurélie Jalaguier-Coudray
  • Jeanne Thomassin-Piana
  • Julie Gonin
  • Jocelyne Chopier
  • Martine Antoine
  • Isabelle Trop
  • Emile Darai
  • Isabelle Thomassin-Naggara
Breast

Abstract

Purpose

To identify pathological features for sample analysis of magnetic resonance imaging-guided vaccum-assisted breast biopsy (MRIgVaBB) to optimize radio pathological correlation and identify discordant benign result.

Material and methods

Databases of two centres were queried to identify MRIgVaBB performed between January 2009 and February 2013. A cohort of 197 women (mean age: 54.5 years (24-77)) with 208 lesions was identified. We retrospectively analyzed all prebiopsy MRI examinations according to the new BI-RADS lexicon, and all biopsy samples to describe the lesion of interest, its interface with the surrounding breast tissue and other associated features.

Results

The malignancy rate was 26.0 % (54/208) with an underestimation rate of 15.67 % (5/32). A visible interface at pathology between a biopsied lesion and the surrounding breast tissue was more frequently identified in mass enhancement compared to NME or focus (p = 0.0003). Regional NME was correlated with a high degree of fibrosis (p = 0.001) and the presence of PASH (p = 0.0007). Linear or segmental NME was correlated with the presence of periductal mastitis (p = 0.0003).

Conclusion

The description of a visible interface between the target lesion and the surrounding tissue is crucial to confirm the correct targeting of an MR mass or a NME.

Key points

Pathological interface correlated with magnetic resonance mass and focal non-mass enhancement (NME).

Linear or segmental NME correlated with mastitis or ductal carcinoma in situ.

Fibrosis and pseudoangiomatous stromal hyperplasia (PASH) are correlated with regional NME.

Keywords

Magnetic Resonance Imaging Pathology Biopsy Neoplasms Breast 

Notes

Acknowledgments

The scientific guarantor of this publication is Isabelle Thomassin-Naggara.

Isabelle Thomassin-Naggara declares a relationship with two companies: General Electric (Honoraries for speaking, travel congress payment) and Olea Medical (Consulting). These relationships have no influence on the design or any result of this article. The other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was not required for this study because our institutional ethics committees approved the study and granted a waiver of informed consent. Methodology: retrospective, observational, multicenter study.

Supplementary material

330_2015_4071_Fig6_ESM.jpg (102 kb)
1A

Supplemental 1: Additional histological features. 1A: Diffuse associated features: Lobular atrophy 1. Presence. 2. Absence (HES × 2.5) (JPEG 101 kb)

330_2015_4071_MOESM1_ESM.tif (16.6 mb)
High resolution image (TIFF 17042 kb)
330_2015_4071_Fig7_ESM.jpg (91 kb)
2A

(JPEG 90 kb)

330_2015_4071_MOESM2_ESM.tif (16.6 mb)
High resolution image (TIFF 17042 kb)
330_2015_4071_Fig8_ESM.jpg (121 kb)
1B

Supplemental 1: Additional histological features. 1B: Diffuse associated features: Cellularity 1. Low 2. moderate or high (HES × 2.5) (JPEG 120 kb)

330_2015_4071_MOESM3_ESM.tif (16.6 mb)
High resolution image (TIFF 17043 kb)
330_2015_4071_Fig9_ESM.jpg (134 kb)
2B

(JPEG 134 kb)

330_2015_4071_MOESM4_ESM.tif (16.6 mb)
High resolution image (TIFF 17043 kb)
330_2015_4071_Fig10_ESM.jpg (32 kb)
1C

Supplemental 1: Additional histological features. 1C: Diffuse associated features: Relative proportion of fibrous and adipose tissue 1.90 %/10 % and 2. 10 %/90 % (Whole slide scanning) (JPEG 31 kb)

330_2015_4071_MOESM5_ESM.tif (6.3 mb)
High resolution image (TIFF 6481 kb)
330_2015_4071_Fig11_ESM.jpg (16 kb)
2C

(JPEG 15 kb)

330_2015_4071_MOESM6_ESM.tif (6.1 mb)
High resolution image (TIFF 6248 kb)
330_2015_4071_Fig12_ESM.jpg (87 kb)
1D

Supplemental 1: Additional histological features. 1D: Focal associated features: Periductal mastitis. In that case, periductal mastitis is associated with ductal ectasia (HES × 2.5) (JPEG 86 kb)

330_2015_4071_MOESM7_ESM.tif (16.6 mb)
High resolution image (TIFF 17042 kb)
330_2015_4071_Fig13_ESM.jpg (157 kb)
1E

Supplemental 1: Additional histological features. 1E: Focal associated features: PASH (HES × 2.5 and insert HES × 10) (JPEG 157 kb)

330_2015_4071_MOESM8_ESM.tif (17.2 mb)
High resolution image (TIFF 17659 kb)
330_2015_4071_Fig14_ESM.jpg (86 kb)
1F

Supplemental 1: Additional histological features. 1F: Focal associated features: Apocrine metaplasia (HES × 10) (JPEG 86 kb)

330_2015_4071_MOESM9_ESM.tif (11.6 mb)
High resolution image (TIFF 11858 kb)
330_2015_4071_Fig15_ESM.jpg (157 kb)
1G

Supplemental 1: Additional histological features. 1G: Interface between lesion and surrounding breast parenchyma. 1. No visible interface between adenosis with usual ductal hyperplasia and surrounding breast parenchyma. 2. Visible interface between fibroadenoma and surrounding adipose breast parenchyma) (HES × 2.5) (JPEG 156 kb)

330_2015_4071_MOESM10_ESM.tif (16.6 mb)
High resolution image (TIFF 17045 kb)
330_2015_4071_Fig16_ESM.jpg (140 kb)
2G

(JPEG 140 kb)

330_2015_4071_MOESM11_ESM.tif (16.6 mb)
High resolution image (TIFF 17043 kb)
330_2015_4071_Fig17_ESM.jpg (11 kb)
2A

Supplemental 2: At MR, this lesion was described as a mass whereas no nodule was found at pathology. However a visible interface between the target lesion and the surrounding tissue was found allowing a good radiopathological correlation. (HES × 2.5). (JPEG 10 kb)

330_2015_4071_MOESM12_ESM.tif (1.7 mb)
High resolution image (TIFF 1714 kb)
330_2015_4071_Fig18_ESM.jpg (147 kb)
2B

(JPEG 147 kb)

330_2015_4071_MOESM13_ESM.tif (1003 kb)
High resolution image (TIFF 1002 kb)

References

  1. 1.
    Orel SG, Schnall MD (2001) MR imaging of the breast for the detection, diagnosis, and staging of breast cancer. Radiology 220:13–30CrossRefPubMedGoogle Scholar
  2. 2.
    Morris EA (2003) Screening for breast cancer with MRI. Semin Ultrasound CT MR 24:45–54CrossRefPubMedGoogle Scholar
  3. 3.
    Sardanelli F, Boetes C, Borisch B et al (2010) Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer 46:1296–1316CrossRefPubMedGoogle Scholar
  4. 4.
    Sung JS, Lee CH, Morris EA et al (2012) Patient follow-up after concordant histologically benign imaging-guided biopsy of MRI-detected lesions. AJR Am J Roentgenol 198:1464–1469CrossRefPubMedGoogle Scholar
  5. 5.
    Li J, Dershaw DD, Lee CH et al (2009) MRI follow-up after concordant, histologically benign diagnosis of breast lesions sampled by MRI-guided biopsy. AJR Am J Roentgenol 193:850–855CrossRefPubMedGoogle Scholar
  6. 6.
    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 24:1176–1185CrossRefPubMedGoogle Scholar
  7. 7.
    Crystal P, Sadaf A, Bukhanov K et al (2011) High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted? Eur Radiol 21:582–589CrossRefPubMedGoogle Scholar
  8. 8.
    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 106:982–990CrossRefPubMedGoogle Scholar
  9. 9.
    Liberman L, Bracero N, Morris E et al (2005) MRI-guided 9-gauge vacuum-assisted breast biopsy: initial clinical experience. AJR Am J Roentgenol 185:183–193CrossRefPubMedGoogle Scholar
  10. 10.
    Orel SG, Rosen M, Mies C, Schnall MD (2006) MR imaging-guided 9-gauge vacuum-assisted core-needle breast biopsy: initial experience. Radiology 238:54–61CrossRefPubMedGoogle Scholar
  11. 11.
    Han BK, Schnall MD, Orel SG, Rosen M (2008) Outcome of MRI-guided breast biopsy. AJR Am J Roentgenol 191:1798–1804CrossRefPubMedGoogle Scholar
  12. 12.
    Perretta T, Pistolese CA, Bolacchi F et al (2008) MR imaging-guided 10-gauge vacuum-assisted breast biopsy: histological characterisation. Radiol Med 113:830–840CrossRefPubMedGoogle Scholar
  13. 13.
    Malhaire C, El Khoury C, Thibault F et al (2010) Vacuum-assisted biopsies under MR guidance: results of 72 procedures. Eur Radiol 20:1554–1562CrossRefPubMedGoogle Scholar
  14. 14.
    Morris EA, Cornstock CE, Lee CH (2013) ACR BI-RADS Magnetic Resonance Imaging. In: ACR BI-RADS Atlas, Breast Imaging REporting and Data System, 5th ed. American College of Radiology, RestonGoogle Scholar
  15. 15.
    Lakhani SR, Schnitt SJ, Hoon Tan P, van de Vijver MJ (2011) WHO classification of Tumours of the breast. SwitzerlandGoogle Scholar
  16. 16.
    Parikh J, Tickman R (2005) Image-guided tissue sampling: where radiology meets pathology. Breast J 11:403–409CrossRefPubMedGoogle Scholar
  17. 17.
    Lehman CD, Deperi ER, Peacock S et al (2005) Clinical experience with MRI-guided vacuum-assisted breast biopsy. AJR Am J Roentgenol 184:1782–1787CrossRefPubMedGoogle Scholar
  18. 18.
    Liberman L, Morris EA, Dershaw DD et al (2003) Ductal enhancement on MR imaging of the breast. AJR Am J Roentgenol 181:519–525CrossRefPubMedGoogle Scholar
  19. 19.
    Thomassin-Naggara I, Trop I, Chopier J, et al. (2011) Nonmasslike enhancement at breast MR imaging: the added value of mammography and US for lesion categorizationGoogle Scholar

Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Chloé Dratwa
    • 1
  • Aurélie Jalaguier-Coudray
    • 2
  • Jeanne Thomassin-Piana
    • 3
  • Julie Gonin
    • 4
  • Jocelyne Chopier
    • 1
  • Martine Antoine
    • 4
  • Isabelle Trop
    • 5
  • Emile Darai
    • 6
    • 7
  • Isabelle Thomassin-Naggara
    • 1
    • 7
    • 8
  1. 1.Department of RadiologyAP-HP, Hôpital TenonParisFrance
  2. 2.Department of RadiologyInstitut Paoli-CalmettesMarseilleFrance
  3. 3.Biopathology DepartmentInstitut Paoli-CalmettesMarseilleFrance
  4. 4.Department of PathologyAP-HP, Hôpital TenonParisFrance
  5. 5.Department of RadiologyHôtel-Dieu de Montréal, Centre Hospitalier de l’Université de MontréalMontréalCanada
  6. 6.Department of Gynaecology and ObstetricsAP-HP, Hôpital TenonParisFrance
  7. 7.UPMC Univ Paris 06, IUCSorbonne UniversitésParisFrance
  8. 8.INSERMParisFrance

Personalised recommendations