J Breast Cancer.  2021 Aug;24(4):377-388. 10.4048/jbc.2021.24.e35.

Magnetic Resonance Imaging-Guided Breast Biopsy in Korea: A 10-Year Follow-Up Experience

• Cha SY
• Ko EY
• Han BK
• Ko ES
• Choi JS
• Park KW
• Lee JE

• KMID: 2519861
• DOI: http://doi.org/10.4048/jbc.2021.24.e35

Abstract

Purpose
To evaluate the accuracy of magnetic resonance imaging (MRI)-guided breast biopsy.
Methods
We retrospectively reviewed the clinical data of 111 consecutive patients referred for MRI-guided breast biopsy after mammography and breast ultrasound between May 2009 and April 2019. After excluding 37 patients without follow-up images (> 2 years), 74 patients (74 lesions) were finally included. We reviewed the histologic results of MRI-guided biopsy and subsequent surgery, post-biopsy management, and breast cancer development during followup. We investigated the false-negative rate, ductal carcinoma in situ (DCIS) underestimation, atypical ductal hyperplasia (ADH) underestimation rate, and technical failure rate of MRIguided biopsy.
Results
Among 74 scheduled MRI-guided biopsies, six were canceled because biopsy was deemed unnecessary, while three failed due to technical difficulties (technical failure rate: 3/68, 4.4%). MRI-guided biopsy was performed in 65 patients, of which 18 patients were diagnosed with malignant lesions, 46 with benign lesions, and one with ADH bordering on DCIS. Subsequent surgery (n = 27) showed DCIS underestimation in three cases (3/7, 43%), ADH underestimation in two cases (1/2, 50%), as well as seven concordant benign and 11 concordant malignant lesions. The overall false-negative rate was 4.3% (2/46). Thirty-eight out of 48 benign lesions were followed-up (median period, 5.8 years; interquartile range, 4.1 years) without subsequent surgery. Thirty-seven concordant benign lesions were stable (n = 27) or disappeared (n = 10); however, the size of one discordant benign lesion increased on follow-up MRI and it was diagnosed as DCIS after 1 year.
Conclusion
MRI-guided biopsy is an accurate method for exclusion of malignancy with a very low false-negative rate.

Keyword

Biopsy; Breast neoplasms; Image-guided biopsy; Magnetic resonance imaging