Breast Center, Kameda Medical Center, Kamogawa, Japan.
Jpn J Radiol. 2010 Aug;28(7):527-33. doi: 10.1007/s11604-010-0464-7. Epub 2010 Aug 27.
The aim of this study was to clarify the frequency of malignancy and the histopathological characteristics of the lesions in patients undergoing magnetic resonance imaging (MRI)-guided vacuum-assisted biopsy (VAB).
A retrospective review of 100 consecutive patients with 102 lesions who had undergone MRI-guided VAB was performed. The biopsies were performed on a 1.5-T MR scanner using a commercially available biopsy system. None of the lesions seen with MRI could be detected by mammography or second-look ultrasonography.
The average lesion sizes of the focus, mass, and nonmass lesions before the biopsy were 4.5, 8.2, and 21 mm, respectively. Twelve patients (12%) had lesions located in the deep portion of the breast, close to the pectoral muscle. The biopsy was successfully performed without important side effects in all patients. Histopathological findings were invasive ductal carcinoma in 6 (6%), in situ carcinoma in 28 (27%), and high-risk and benign in 68 (67%). Two high-risk lesions were upgraded to ductal carcinoma in situ (DCIS), and three DCIS lesions were upgraded to invasive ductal carcinoma at surgical excision.
The high rate of DCIS might be a unique feature among Japanese women. However, MRI-guided VAB is necessary for MRI-only visible suspicious lesions in Japan.
本研究旨在阐明在接受磁共振成像（MRI）引导下真空辅助活检（VAB）的患者中，病变的恶性肿瘤发生率和组织病理学特征。
对 100 例连续患者的 102 个病灶进行了回顾性分析，这些患者均接受了 MRI 引导下 VAB 检查。活检在 1.5-T MR 扫描仪上使用商业上可获得的活检系统进行。MRI 所见的所有病灶均无法通过乳腺钼靶摄影或二次超声检查检测到。
活检前病灶的焦点、肿块和非肿块的平均大小分别为 4.5、8.2 和 21mm。12 名患者（12%）的病灶位于乳房深部，靠近胸肌。所有患者均成功进行了活检，无重要的副作用。组织病理学检查结果显示浸润性导管癌 6 例（6%），原位癌 28 例（27%），高危和良性 68 例（67%）。2 个高危病灶升级为导管原位癌（DCIS），3 个 DCIS 病灶在手术切除时升级为浸润性导管癌。
日本女性中 DCIS 的高发生率可能是一个独特的特征。然而，在日本，对于仅在 MRI 上可见的可疑病灶，MRI 引导下 VAB 是必要的。
