Department of Radiology, Breast Imaging Section, Memorial Sloan-Kettering Cancer Center, Evelyn H. Lauder Breast Center, New York, NY 10065, USA.
Radiology. 2011 Oct;261(1):92-9. doi: 10.1148/radiol.11100720. Epub 2011 Aug 18.
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.
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% confidence interval (CI) was calculated.
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 significantly 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 fibroglandular 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 first year, with a decrease in subsequent years (14 of 102 [14%] vs 56 of 805 [7%], P = .025). A significantly lower rate was found in women with synchronous breast cancer (nine of 240 [4%] vs 61 of 667 [9%], P = .007), and a significantly 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 identified. 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%).
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.
确定由于病变未可视化而取消磁共振（MR）成像引导下乳腺活检的比率，并评估这些病例的相关特征和结果数据。
在获得机构审查委员会批准后，对 2004 年至 2008 年期间计划行 MR 成像引导下乳腺活检的 907 例患者进行了 HIPAA 合规性回顾性研究，其中豁免了知情同意的要求。在 70 例患者中，由于病变未可视化而取消了 MR 成像活检。回顾性分析了病历和影像学资料，以确定患者、实质、病变特征和结果数据。采用 Fisher 确切检验进行统计学分析。计算 95%置信区间（CI）。
由于病变未可视化而取消 MR 引导活检的发生率为 8%（70/907 例患者和 74/911 个病变）。与显著更高的取消率相关的因素包括显著和中度与轻度和最小背景实质增强（38/316 [12%]与 32/591 [5%]，P=0.001）、极不均匀和不均匀致密与散在纤维腺体密度和脂肪实质体积（64/712 [9%]与 6/195 [3%]，P=0.006），以及 1cm 或更小的病变（52/520 [10%]与 22/391 [6%]，P=0.02）。每年取消率在第一年最高，随后逐年下降（14/102 [14%]与 56/805 [7%]，P=0.025）。在患有同步乳腺癌的女性中发现的取消率显著较低（9/240 [4%]与 61/667 [9%]，P=0.007），在有癌症病史的女性中发现的取消率显著较高（35/315 [11%]与 35/592 [6%]，P=0.01）。在 58 例接受 MR 成像随访的女性中，未发现癌症。在取消活检的 3 例女性中，有 1 例在 MR 显示病变的同一象限中患有导管原位癌。在接受 MR 成像或病理随访的 61 例女性中，癌症检出率为 2%（1/61）（95%CI：0.4%，9%）。
由于病变未可视化，8%的患者行 MR 成像引导下乳腺活检被取消。尽管取消活检的病变的癌症检出率较低（95%CI：0%，9%），但短期随访的 MR 成像仍很谨慎。
