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MR imaging-guided 10-gauge vacuum-assisted breast biopsy: histological characterisation

Imaging RM. Biopsia della mammella con sistema di retro aspirazione RM guidato da 10 gauge: caratterizzazione istologica

  • Breast Radiology/Senologia
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate a handheld vacuum-assisted device for magnetic resonance imaging (MRI)-guided breast biopsy.

Materials and methods

In 47 patients, a total of 47 suspicious breast lesions (mean maximum diameter 9 mm) seen with MRI (no suspicious changes on breast ultrasound or mammography) were sampled using a 10-gauge vacuum-assisted breast biopsy (VAB) device under MRI guidance. Histology of biopsy specimens was compared with final histology after surgery or with follow-up in benign lesions.

Results

Technical success was achieved in all biopsies. Histological results from VAB revealed malignancy in 15 lesions (32%), atypical ductal hyperplasia in four lesions (8%) and benign findings in 28 lesions (60%). One of four lesions with atypical ductal hyperplasia was upgraded to ductal carcinoma in situ after surgery. One of seven lesions showing ductal carcinoma was upgraded to invasive carcinoma after surgery. Two lesions diagnosed as infiltrating carcinoma by VAB were not validated at excisional biopsy due to complete removal of the lesion during the procedure. During the follow-up (mean 18 months) of histologically benign lesions, we observed no cases of breast cancer development. Because of morphological changes on follow-up MRI scans, two lesions underwent surgical excision, which confirmed their benign nature. Besides minor complications (massive bleeding, n=1) requiring no further therapeutic intervention, no complications occurred.

Conclusions

MRI-guided biopsy of breast lesions using a handheld vacuum-assisted device is a safe and effective method for the workup of suspicious lesions seen on breast MRI alone.

Riassunto

Obiettivo

Valutare l’accuratezza diagnostica dei prelievi con sistema portatile ad aspirazione retroazionata (VAB) 10 gauge sotto-guida RM nella caratterizzazione delle lesioni mammarie visibili unicamente alla RM.

Materiali e metodi

47 lesioni (diametro massimo 9 mm) visibili unicamente all’esame RM, sono state caratterizzate usando un sistema portatile ad aspirazione retroazionata (VAB) con ago da 10 Gauge, sotto guida RM. L’istologia delle biopsie VAB è stata confrontata con l’istologia definitiva dopo l’escissione chirurgica o con i reperti di follow-up.

Risultati

Il successo tecnico è stato ottenuto in tutti i casi. I risultati istologici della biopsia VAB hanno mostrato 15 lesioni maligne (32%), 4 lesioni classificabili come iperplasia duttale atipica (ADH) (8%), e 28 lesioni come benigne (60%). Alla istologia definitiva una delle quattro lesioni classificate come ADH è stata riclassificata come carcinoma duttale in situ (DCIS), mentre una delle lesioni classificate come DCIS è stata riclassificata come carcinoma invasivo. Due lesioni diagnosticate al VAB come carcinoma infiltrante non sono state riscontrate alla istologia definitiva, probabilmente a causa della totale rimozione durante la procedura VAB. Il follow-up delle lesioni benigne ha confermato la benignità delle lesioni. Due lesioni benigne che all’Imaging RM hanno mostrato una modificazione della morfologia, sono andate incontro ad intervento chirurgico che ha confermato la benignità della lesione. Ad eccezione di un massivo sanguinamento in 1 caso, non si sono osservate complicanze.

Conclusioni

I prelievi VAB sotto-guida RM sono una mammetodica sicura ed efficace per la caratterizzazione delle lesioni mammarie visibili unicamente all’RM.

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References/Bibliografia

  1. Berg WA, Gutierrez L, NessAiver MS et al (2004) Diagnostic accuracy of mammography, clinical examination, US and MR imaging in preoperative assessment of breast cancer. Radiology 233:830–844

    Article  PubMed  Google Scholar 

  2. Orel SG, Schnall MD (2001) MR imaging of the breast for the detection, diagnosis, and staging of breast cancer Radiology 220:13–30

    PubMed  CAS  Google Scholar 

  3. Orel SG, Schnall MD, Powell CM et al (1995) Staging of suspected breast cancer: effect of MR imaging and MR-guided biopsy. Radiology 196:115–121

    PubMed  CAS  Google Scholar 

  4. Chen X, Lehman CD, Dee KE (2004) MRI-guided breast biopsy: clinical experience with 14-gauge stainless steel core biopsy needle AJR Am J Roentgenol 182:1075–1080

    PubMed  Google Scholar 

  5. Liberman L, Morris EA, Dershaw DD et al (2003) Fast MRI-guided vacuumassisted breast biopsy: initial experience, AJR Am J Roentgenol 181:1283–1293

    PubMed  Google Scholar 

  6. Orel SG, Rosen M, Mies C, Schnall MD (2006) MR imaging-guided 9-gauge vacuum-assisted core-needle breast biopsy: initial experience. Radiology 238:54–61

    Article  PubMed  Google Scholar 

  7. Kuhl CK, Elevelt A, Leutner CC et al (1997) Interventional breast MR imaging: clinical use of a stereotactic localization and biopsy device. Radiology 204:667–675

    PubMed  CAS  Google Scholar 

  8. Helbich TH, Matzek W, Fushsjager MH (2004) Stereotactic and ultrasoundguided breast biopsy. Eur Radiol 14:383–393

    Article  PubMed  CAS  Google Scholar 

  9. Heywang-Kobrunner SH, Heinig A, Pickuth D et al (2000) Interventional MRI of the breast: lesion localisation and biopsy. Eur Radiol 10:36–45

    Article  PubMed  CAS  Google Scholar 

  10. Kuhl CK (2002) Interventional breast MRI: needle localisation and core biopsies. J Exp Clin Cancer Res 21(3 Suppl):65–68

    PubMed  CAS  Google Scholar 

  11. La Nette FS, Ronda HT, Mancino AT et al (2001) Magnetic Resonance imaging-guided core needle biopsy and needle localized excision of occult breast lesions. Am J Surgery 182:414–418

    Article  Google Scholar 

  12. Jackman RJ, Burbank F, Parker SH et al (1997) Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-Gauge, directional, vacuum assisted biopsy. Radiology 204:485–488

    PubMed  CAS  Google Scholar 

  13. Kettritz U, Rotter K, Scheer I et al (2004) Stereotactic vacuum assissted breast biopsy in 2874 patients: a multicenter study. Cancer 100:245–251

    Article  PubMed  Google Scholar 

  14. Perlet C, Heywang-Kobrunner SH, Heinig A et al (2006) Resonance-guided vacuum-assisted breast biopsy results from a European Multicenter Study of 538 lesions. Cancer 106:982–990

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Terapia Radiante, Policlinico Universitario “Tor Vergata” (PTV), Viale Oxford 81, 00133, Roma, Italy

    T. Perretta, C. A. Pistolese, F. Bolacchi, E. Cossu, V. Fiaschetti & G. Simonetti

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  1. T. Perretta
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  2. C. A. Pistolese
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  3. F. Bolacchi
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  4. E. Cossu
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  5. V. Fiaschetti
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  6. G. Simonetti
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Correspondence to T. Perretta.

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Perretta, T., Pistolese, C.A., Bolacchi, F. et al. MR imaging-guided 10-gauge vacuum-assisted breast biopsy: histological characterisation. Radiol med 113, 830–840 (2008). https://doi.org/10.1007/s11547-008-0289-y

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  • DOI: https://doi.org/10.1007/s11547-008-0289-y

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