Department of Radiology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Radiol Oncol. 2012 Jun;46(2):97-105. doi: 10.2478/v10019-012-0016-0. Epub 2012 May 11.
Like all breast imaging modalities MRI has limited specificity and the positive predictive value for lesions detected by MRI alone ranges between 15 and 50%. MRI guided procedures (needle biopsy, presurgical localisation) are mandatory for suspicious findings visible only at MRI, with potential influence on therapeutic decision. The aim of this retrospective study was to evaluate our initial clinical experience with MRI-guided vacuum-assisted breast biopsy as an alternative to surgical excision and to investigate the outcome of MRI-guided breast biopsy as a function of the MRI features of the lesions. PATIENTS AND METHODS.: In 14 women (median age 51 years) with 14 MRI-detected lesions, MRI-guided vacuum-assisted breast biopsy was performed. We evaluated the MRI findings that led to biopsy and we investigated the core and postoperative histology results and follow-up data.
The biopsy was technically successful in 14 (93%) of 15 women. Of 14 biopsies in 14 women, core histology revealed 6 malignant (6/14, 43%), 6 benign (6/14, 43%) and 2 high-risk (2/14, 14%) lesions. Among the 6 cancer 3 were invasive and 3 were ductal carcinoma in situ (DCIS). The probability of malignancy in our experience was higher for non-mass lesion type and for washout and plateau kinetics.
Our initial experience confirms that MRI-guided vacuum-assisted biopsy is fast, safe and accurate alternative to surgical biopsy for breast lesions detected at MRI only.
与所有乳腺影像学检查方法一样,磁共振成像(MRI)的特异性有限,单独通过 MRI 检测到的病变的阳性预测值在 15%至 50%之间。对于仅在 MRI 上可见的可疑发现,需要进行 MRI 引导的程序(如活检、术前定位),这可能会对治疗决策产生影响。本回顾性研究的目的是评估我们在 MRI 引导下真空辅助乳腺活检方面的初步临床经验,作为手术切除的替代方法,并研究 MRI 引导下乳腺活检的结果与病变的 MRI 特征之间的关系。
在 14 名女性(中位年龄 51 岁)的 14 个 MRI 检测到的病变中,进行了 MRI 引导下真空辅助乳腺活检。我们评估了导致活检的 MRI 发现,并研究了核心和术后组织学结果以及随访数据。
15 名女性中的 14 名(93%)成功进行了技术上的活检。在 14 名女性的 14 次活检中,核心组织学显示 6 个恶性(6/14,43%)、6 个良性(6/14,43%)和 2 个高风险(2/14,14%)病变。在这 6 例癌症中,有 3 例为浸润性癌,3 例为导管原位癌(DCIS)。在我们的经验中,非肿块型病变类型、洗脱和平台动力学与恶性肿瘤的发生概率更高。
我们的初步经验证实,MRI 引导下真空辅助活检是一种快速、安全、准确的替代方法,可用于仅在 MRI 上检测到的乳腺病变。