Abstract
Background
In the United States and Europe, MR-guided vacuum-assisted biopsy (VAB) is required for MR-only visible suspicious lesions that cannot be identified with mammography or ultrasonography. However, it is controversial as to whether MR-guided VAB is essential or not in Japan. The purpose of this study was to clarify the frequency of malignancy among the patients that underwent MR-guided VAB, and to discuss the need for this technique in Japan.
Methods
This study was approved by the Institutional Review Board of our hospital. A retrospective review was performed of 30 consecutive patients who had undergone MR-guided 11-gauge VAB. The biopsies were performed on a 1.5 T MR scanner using a commercially available biopsy system. All lesions seen with MRI could not be detected by mammography and second-look ultrasonography.
Results
All 30 lesions were assessed as category 4 or 5. The average lesion size of a mass enhancement before biopsy was 0.7 cm, and the average lesion size of a non-mass-like enhancement was 2.3 cm. The average number of cores of VAB was 19. The median time required to perform the VAB procedure was 35 min. The biopsy was successfully performed without important side effects in all patients. Histopathological findings were invasive ductal carcinoma in one (3%); ductal carcinoma in situ (DCIS) in seven (23%); and benign in 22 (73%). In one case, atypical ductal hyperplasia at VAB was upgraded to DCIS at surgical excision.
Conclusion
MR-guided VAB can be performed safely and it is needed for MR-only visible suspicious lesions in Japan.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Orel SG, Schnall MD, Newman RW, Powell CM, Torosian MH, Rosato EF. MR imaging-guided localization and biopsy of breast lesions: initial experience. Radiology. 1994;193:97–102.
Liberman L, Bracero N, Morris E, Thornton C, Dershaw DD. MRI-guided 9-gauge vacuum-assisted breast biopsy: initial clinical experience. AJR Am J Roentgenol. 2005;185:183–93.
Orel SG, Rosen M, Mies C, Schnall MD. MR imaging-guided 9-gauge vacuum-assisted core-needle breast biopsy: initial experience. Radiology. 2006;238:54–61.
Fischer U, Vosshenrich R, Döler W, Hamadeh A, Oestmann JW, Grabbe E. MR imaging-guided breast intervention: experience with two systems. Radiology. 1995;195:533–8.
Heywang-Köbrunner SH, Heinig A, Schaumlöffel U, Viehweg P, Buchmann J, Lampe D, et al. MR-guided percutaneous excisional and incisional biopsy of breast lesions. Eur Radiol. 1999;9:1656–65.
Kuhl CK, Morakkabati N, Leutner CC, Schmiedel A, Wardelmann E, Schild HH. MR imaging-guided large-core (14-gauge) needle biopsy of small lesions visible at breast MR imaging alone. Radiology. 2001;220:31–9.
Prat X, Sittek H, Grosse A, Baath L, Perlet C, Alberich T, et al. European quadricentric evaluation of a breast MR biopsy and localization device: technical improvements based on phase-I evaluation. Eur Radiol. 2002;12:1720–7.
Viehweg P, Heinig A, Amaya B, Alberich T, Laniado M, Heywang-Köbrunner SH. MR-guided interventional breast procedures considering vacuum biopsy in particular. Eur J Radiol. 2002;42:32–9.
Perlet C, Heinig A, Prat X, Casselman J, Baath L, Sittek H, et al. Multicenter study for the evaluation of a dedicated biopsy device for MR-guided vacuum biopsy of the breast. Eur Radiol. 2002;12:1463–70.
Perlet C, Heywang-Kobrunner SH, Heinig A, Sittek H, Casselman J, Anderson I, et al. Magnetic resonance-guided, vacuum-assisted breast biopsy: Results from a European multicenter study of 538 lesions. Cancer. 2006;106:982–90.
Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, et al. Russell CA; American Cancer Society Breast Cancer Advisory Group American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007;57:75–89.
Mann RM, Kuhl CK, Kinkel K, Boetes C. Breast MRI: guidelines from the European Society of Breast Imaging. Eur Radiol. 2008;18:1307–18.
Tozaki M, Yamashiro N, Fukuma E. MR-guided vacuum-assisted breast biopsy using a non-titanium needle. Magn Reson Med Sci. 2007;6:259–64.
Yamashiro N, Tozaki M, Higa K, Fukuma E. A case of multicentric breast cancer diagnosed by MRI-guided biopsy (in Japanese with English abstract). J Jpn Surg Assoc. 2008;69:1033–6.
American College of Radiology (2003) Breast imaging reporting and data system (BI-RADS), 4th edn. American College of Radiology, Reston, VA.
Fischer U, Kopka L, Grabbe E. Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology. 1999;213:881–8.
Tozaki M, Fukuda K. High-spatial-resolution MRI of non-masslike breast lesions: interpretation model based on BI-RADS MRI descriptors. Am J Roentgenol. 2006;187:330–7.
Sakamoto N, Tozaki M, Higa K, Tsunoda Y, Ogawa T, Abe S, et al. Categorization of non-mass-like breast lesions detected by MRI. Breast Cancer. 2008;15:241–6.
World Health Organization. Classification of tumors: pathology and genetics of tumours of the breast and female genital organs. Lyon: IARC; 2003.
LaTrenta LR, Menell JH, Morris EA, Abramson AF, Dershaw DD, Liberman L. Breast lesions detected with MR imaging: utility and histopathologic importance of identification with US. Radiology. 2003;227:856–61.
Sakamoto N, Tozaki M, Fukuma E, Higa K, Tsunoda Y, Abe S, et al. The role of ultrasound-guided vacuum-assisted biopsy in the management of MRI-detected lesions (in Japanese with English abstract). Jpn J Breast Cancer. 2007;22:275–9.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Tozaki, M., Yamashiro, N., Suzuki, T. et al. MR-guided vacuum-assisted breast biopsy: is it an essential technique?. Breast Cancer 16, 121–125 (2009). https://doi.org/10.1007/s12282-008-0074-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12282-008-0074-8