Ferré Romuald, AlSharif Shaza, Aldis Ann, Mesurolle Benoît
Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, Montréal, Québec, Canada; Department of Radiology, North Ontario School of Medicine, Thunder Bay Regional Health Center, Thunder Bay, Ontario, Canada.
Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, Montréal, Québec, Canada; Department of Medical Imaging, Ministry of National Guard Health Affairs, King Abdulaziz Bin Saud University for Health Sciences, Jeddah, Saudi Arabia.
Can Assoc Radiol J. 2017 Nov;68(4):401-408. doi: 10.1016/j.carj.2017.03.003. Epub 2017 Aug 21.
The study sought to investigate the outcome of breast magnetic resonance-guided biopsies as a function of the indication for magnetic resonance imaging (MRI), the MRI features of the lesions, and the performance or not of a targeted second-look ultrasound (SLUS) prior breast MRI-guided biopsy.
We identified 158 women with MRI-detected breast lesions scheduled for MRI-guided biopsy (2007-2013). Patient demographics, performance of targeted SLUS, imaging characteristics, and subsequent pathology results were reviewed.
Three biopsies were deferred, and 155 lesions were biopsied under MRI guidance (155 women; median age 55.14 years; range 27-80 years). Ninety-eight women underwent a SLUS prior to the MRI-guided biopsy (63%). Of the 155 biopsied lesions, 23 (15%) were malignant, 106 (68%) were benign, and 26 (17%) were high risk. Four of 15 surgically excised high-risk lesions were upgraded to malignancy (27%). Most of the biopsied lesions corresponded to non-mass-like enhancement (81%, 126 of 155) and most of the biopsies (52%, 81 of 155) were performed in a screening context. No demographic or MRI features were associated with malignancy. No differences were noted between the 2 subgroups (prior SLUS vs no prior SLUS) except for the presence of a synchronous carcinoma associated with a likelihood of targeted SLUS before MRI-guided biopsy (P = .001).
A negative SLUS does not influence the pathology outcome of a suspicious lesion biopsied under MR guidance.
本研究旨在探讨乳腺磁共振引导下活检的结果，该结果取决于磁共振成像（MRI）的指征、病变的MRI特征以及在乳腺MRI引导下活检前是否进行靶向二次超声检查（SLUS）。
我们确定了158例计划进行MRI引导下活检的MRI检测到乳腺病变的女性（2007 - 2013年）。回顾了患者的人口统计学特征、靶向SLUS的实施情况、影像学特征以及后续的病理结果。
3例活检被推迟，155个病变在MRI引导下进行了活检（155名女性；中位年龄55.14岁；范围27 - 80岁）。98名女性在MRI引导下活检前进行了SLUS（63%）。在155个活检病变中，23个（15%）为恶性，106个（68%）为良性，26个（17%）为高危。15个手术切除的高危病变中有4个升级为恶性（27%）。大多数活检病变对应于非肿块样强化（81%，155个中的126个），并且大多数活检（52%，1/55个中的81个）是在筛查背景下进行的。没有人口统计学或MRI特征与恶性肿瘤相关。除了在MRI引导下活检前存在与靶向SLUS可能性相关的同步癌外，两个亚组（术前SLUS与未术前SLUS）之间没有差异（P = 0.001）。
阴性SLUS不影响在MR引导下活检的可疑病变的病理结果。
