Cancellation of MR imaging-guided breast biopsy due to lesion nonvisualization: Frequency and follow-up Journal Article


Authors: Brennan, S. B.; Sung, J. S.; Dershaw, D. D.; Liberman, L.; Morris, E. A.
Article Title: Cancellation of MR imaging-guided breast biopsy due to lesion nonvisualization: Frequency and follow-up
Abstract: Purpose: To determine the rate of canceled magnetic resonance (MR) imaging-guided breast biopsies due to nonvisualization of the lesion and to assess associated features and outcome data for these cases. Materials and Methods: With the approval of the institutional review board, a HIPAA-compliant retrospective review, in which the requirement for informed consent was waived, was performed for 907 patients scheduled for MR imaging-guided breast biopsy from 2004 to 2008. In 70 patients, MR imaging biopsy was canceled due to lesion nonvisualization. Medical records and imaging studies were reviewed to identify patient, parenchymal, lesion features and outcome data. Statistical analysis was performed with the Fisher exact test. The 95% confi dence interval (CI) was calculated. Results: Cancellation of MR-guided biopsy due to lesion nonvisualization occurred in 8% (70 of 907) of patients and in 8% (74 of 911) of lesions. Factors associated with a signifi cantly higher cancellation rate included marked and moderate versus mild and minimal background parenchymal enhancement (38 of 316 [12%] vs 32 of 591 [5%], P = .001), extremely and heterogeneously dense versus scattered fi broglandular densities and fatty parenchymal volume (64 of 712 [9%] vs six of 195 [3%], P = .006), and lesions 1 cm or less in size (52 of 520 [10%] vs 22 of 391 [6%], P = .02).The rate of cancellation per year was highest in the fi rst year, with a decrease in subsequent years (14 of 102 [14%] vs 56 of 805 [7%], P = .025). A signifi cantly lower rate was found in women with synchronous breast cancer (nine of 240 [4%] vs 61 of 667 [9%], P = .007), and a signifi cantly higher rate was found in women with a history of cancer (35 of 315 [11%] vs 35 of 592 [6%], P = .01). Among 58 women who had MR imaging follow-up, no cancers were identifi ed. Among three women who underwent mastectomy after cancellation, one had ductal carcinoma in situ in the same quadrant as the MR-depicted lesion. The cancer detection rate among 61 women who underwent either MR imaging or pathologic follow-up was 2% (one of 61) (95% CI: 0.4%, 9%). Conclusion: MR imaging-guided breast biopsy was canceled due to lesion nonvisualization in 8% of the patients. Although the cancer detection rate among the lesions for which biopsy was canceled is low (95% CI: 0%, 9%), short-term follow-up MR imaging is prudent. © RSNA, 2011.
Keywords: adult; human tissue; aged; major clinical study; histopathology; nuclear magnetic resonance imaging; follow up; mastectomy; retrospective study; disease severity; image quality; biopsy technique; gadolinium pentetate; intraductal carcinoma; image display; breast biopsy; adipose tissue; breast lesion; tissue structure
Journal Title: Radiology
Volume: 261
Issue: 1
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2011-10-01
Start Page: 92
End Page: 99
Language: English
DOI: 10.1148/radiol.11100720
PROVIDER: scopus
PUBMED: 21852565
DOI/URL:
Notes: --- - "Export Date: 2 November 2011" - "CODEN: RADLA" - "Source: Scopus"
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MSK Authors
  1. Janice Sinae Sung
    67 Sung
  2. D David Dershaw
    223 Dershaw
  3. Laura Liberman
    176 Liberman
  4. Elizabeth A Morris
    336 Morris
  5. Sandra B Brennan
    40 Brennan