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Elfgen C, Varga Z, Breitling K, Pauli E, Schwegler-Guggemos D, Kampmann G, Kubik-Huch RA, Leo C, Lepori D, Sonnenschein M, Tausch C, Schrading S. Long-Term Follow-Up of High-Risk Breast Lesions at Vacuum-Assisted Biopsy without Subsequent Surgical Resection. Breast Care (Basel) 2024; 19:62-72. [PMID: 38384485 PMCID: PMC10878709 DOI: 10.1159/000533673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/16/2023] [Indexed: 02/23/2024] Open
Abstract
Introduction B3-lesions of the breast are a heterogeneous group of neoplasms, associated with a higher risk of breast cancer. Recent studies show a low upgrade rate into malignancy after subsequent open surgical excision (OE) of most B3-lesions when proven by vacuum-assisted biopsy (VAB). However, there is a lack of long-term follow-up data after VAB of high-risk lesions. The primary aim of this study was to demonstrate whether follow-up of B3 lesions is a beneficial and reliable alternative to OE in terms of long-term outcome. The secondary aim was to identify patient and lesion characteristics of B3 lesions for which OE is still necessary. Methods This retrospective multicenter study was conducted at 8 Swiss breast centers between 2010 and 2019. A total of 278 women (mean age: 53.5 ± 10.7 years) with 286 B3-lesions who had observation only and who had at least 24 months of follow-up were included. Any event during follow-up (ductal carcinoma in situ [DCIS], invasive cancer, new B3-lesion) was systematically recorded. Data from women who had an event during follow-up were compared with those who did not. The results for the different B3 lesions were analyzed using the t test and Fisher's exact test. A p value of <0.05 was considered statistically significant. Results The median follow-up interval was 59 months (range: 24-143 months) with 52% (148/286) having a follow-up of more than 5 years. During follow-up, in 42 women, 44 suspicious lesions occurred, with 36.4% (16/44) being invasive cancer and 6.8% (3/44) being DCIS. Thus, 6.6% (19/286) of all women developed malignancy during follow-up after a median follow-up interval of 6.5 years (range: 31-119 months). The initial histology of the B3 lesion influenced the subsequent occurrence of a malignant lesion during follow-up (p < 0.038). The highest malignancy-developing rate was observed in atypical ductal hyperplasia (ADH) (24%, 19/79), while all other B3-lesions had malignant findings ipsi- and contralateral between 0% and 6%. The results were not influenced by the VAB method (Mx-, US-, magnetic resonance imaging-guided), the radiological characteristics of the lesion, or the age or menopausal status of the patient (p > 0.12). Conclusion With a low risk of <6% of developing malignancy, VAB followed by long-term follow-up is a safe alternative to OE for most B3-lesions. A higher malignancy rate only occurred in ADH (24%). Based on our results, radiological follow-up should be bilateral, preferable using the technique of initial diagnosis. As we observed a late peak (6-7 years) of breast malignancies after B3-lesions, follow-up should be continued for a longer period (>10 years). Knowledge of these long-term outcome results will be helpful in making treatment decisions and determining the optimal radiological follow-up interval.
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Affiliation(s)
- Constanze Elfgen
- Breast-Center Zurich, Zurich, Switzerland
- Department of Medicine, University of Witten-Herdecke, Witten, Germany
| | - Zsuzsanna Varga
- Department of Pathology and Molecular Pathology, University Hospital Zürich, Zurich, Switzerland
| | - Katrin Breitling
- Breast Center, Kantonsspital Schaffhausen, Schaffhausen, Switzerland
| | - Eliane Pauli
- Breast Center, Kantonsspital Frauenfeld, Frauenfeld, Switzerland
| | | | - Gert Kampmann
- Centro di Radiologia e Senologia Luganese, Lugano, Switzerland
| | | | - Cornelia Leo
- Breast Center, Kantonsspital Baden, Baden, Switzerland
| | | | | | - Christoph Tausch
- Breast-Center Zurich, Zurich, Switzerland
- Department of Medicine, University of Basel, Basel, Switzerland
| | - Simone Schrading
- Department of Radiology and Nuclear Medicine, Kantonsspital Lucerne, Lucerne, Switzerland
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2
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Wang LC, Rao S, Schacht D, Bhole S. Reducing False Negatives in Biopsy of Suspicious MRI Findings. JOURNAL OF BREAST IMAGING 2023; 5:597-610. [PMID: 38416912 DOI: 10.1093/jbi/wbad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Indexed: 03/01/2024]
Abstract
Breast MRI is a highly sensitive imaging modality that often detects findings that are occult on mammography and US. Given the overlap in appearance of benign and malignant lesions, an accurate method of tissue sampling for MRI-detected findings is essential. Although MRI-directed US and correlation with mammography can be helpful for some lesions, a correlate is not always found. MRI-guided biopsy is a safe and effective method of tissue sampling for findings seen only on MRI. The unique limitations of this technique, however, contribute to false negatives, which can result in delays in diagnosis and adverse patient outcomes; this is of particular importance as most MRI examinations are performed in the high-risk or preoperative setting. Here, we review strategies to minimize false negatives in biopsy of suspicious MRI findings, including appropriate selection of biopsy modality, use of meticulous MRI-guided biopsy technique, management after target nonvisualization, assessment of adequate lesion sampling, and determination of radiology-pathology concordance. A proposed management algorithm for MRI-guided biopsy results will also be discussed.
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Affiliation(s)
- Lilian C Wang
- Northwestern Medicine, Department of Radiology, Chicago, IL, USA
| | - Sandra Rao
- Northwestern Medicine, Department of Radiology, Chicago, IL, USA
| | - David Schacht
- Northwestern Medicine, Department of Radiology, Chicago, IL, USA
| | - Sonya Bhole
- Northwestern Medicine, Department of Radiology, Chicago, IL, USA
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3
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Kuhl CK. What the Future Holds for the Screening, Diagnosis, and Treatment of Breast Cancer. Radiology 2023; 306:e223338. [PMID: 36802999 DOI: 10.1148/radiol.223338] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- Christiane K Kuhl
- From the Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstr 30, 52074 Aachen, RWTH, Germany
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4
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Perretta T, Meucci R, Serio ML, Caliandro A, Censi M, Beninati E, Collura A, Vanni G, Giacobbi E, Anemona L, Pistolese CA. Small vascular lesions of the breast diagnosed by magnetic resonance imaging‐guided vacuum assisted biopsy: Report of 2 cases. Radiol Case Rep 2022; 17:2492-2500. [PMID: 35586166 PMCID: PMC9109119 DOI: 10.1016/j.radcr.2022.03.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 11/03/2022] Open
Abstract
Vascular lesions of the breast comprise a heterogeneous group that includes a variety of benign, atypical, and malignant lesions. These are a diagnostic challenge given variable clinical, radiological and pathological presentation, especially when they are small and asymptomatic. We present 2 cases of these rare lesions of the breast which were occult to mammographics and ultrasound studies. Both the lesions were detected only on magnetic resonance imaging, most helpful in the diagnosis of these rare tumor. Histopathological examinations following the magnetic resonance guided biopsies, were initially interpreted as negative for breast cancer in both cases. These turned out to be respectively a low grade angiosarcoma and a benign vascular lesion after a new histopathological examination following a larger magnetic resonance guided biopsies performed in light of the radiology-pathology discordance. Although rare, it is important to consider vascular tumours of the breast; radiologists need to be aware such tumors may present non-specific imaging features.
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5
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Meucci R, Pistolese CA, Perretta T, Luciani ML, Beninati E, Di Tosto F, D'Alfonso V, Buonomo OC. Primary Extranodal Follicular T-Cell Lymphoma and Ductal Breast Carcinoma Diagnosed by a Magnetic Resonance Imaging-Guided Vacuum-Assisted Biopsy: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e929309. [PMID: 34226439 PMCID: PMC8272939 DOI: 10.12659/ajcr.929309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Extranodal non-Hodgkin lymphomas (NHL) are low-grade B-cell lymphomas and the breast is not a common site for this condition. This case report describes a 62-year-old woman with a primary NHL and ductal carcinoma in situ (DCIS) of the left breast diagnosed by a magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsy. The simultaneous diagnosis of breast cancer and NHL is rare, with few cases described in the literature. Primary breast lymphomas account only for 0.04% to 0.5% of breast malignancies. CASE REPORT In November 2016, a 62-year-old woman was treated for a peripheral T-cell lymphoma (follicular helper T-cell phenotype) of the left upper central breast; later she underwent periodic breast imaging follow-ups. In October 2018, MRI revealed a focal 33-mm non-mass contrast enhancement (according to the Breast Imaging Reporting and Data System -MRI lexicon of the American College of Radiology) in the lower external quadrant of the left breast. Neither mammography nor ultrasonography demonstrated any suspicious features. The multidisciplinary medical team performed an MRI-guided vacuum-assisted breast biopsy and the histological analysis confirmed the diagnosis of a DCIS. Subsequently, she underwent surgery resulting in eradication of the disease and has had regular follow-ups, including mammography, ultrasonography, and MRI. CONCLUSIONS This is a rare case of both a primary NHL of the breast and DCIS, which was detected only by MRI. It highlights the role of an MRI-guided vacuum-assisted breast biopsy, which allows an accurate and economic diagnosis in case of suspicious findings on MRI. We recommend the use of MRI in follow-ups for patients with previous breast lymphomas (high-risk patients).
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Affiliation(s)
- Rosaria Meucci
- UOC of Diagnostic Imaging, Policlinico Tor Vergata (PTV) University, Rome, Italy.,UOSD Breast Unit, Department of Surgical Science, Policlinico Tor Vergata (PTV) University, Rome, Italy
| | | | - Tommaso Perretta
- UOC of Diagnostic Imaging, Policlinico Tor Vergata (PTV) University, Rome, Italy
| | | | - Emanuela Beninati
- UOC of Diagnostic Imaging, Policlinico Tor Vergata (PTV) University, Rome, Italy
| | - Federica Di Tosto
- UOC of Diagnostic Imaging, Policlinico Tor Vergata (PTV) University, Rome, Italy
| | | | - Oreste Claudio Buonomo
- UOSD Breast Unit, Department of Surgical Science, Policlinico Tor Vergata (PTV) University, Rome, Italy
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Ram S, Regen-Tuero H, Baird GL, Lourenco AP. Compliance with Short-Interval Follow-up MRI after Benign Concordant MRI-guided Breast Biopsy. JOURNAL OF BREAST IMAGING 2021; 3:64-71. [PMID: 38424838 DOI: 10.1093/jbi/wbaa089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To evaluate compliance with short-interval follow-up MRI after benign concordant MRI-guided breast biopsy. METHODS This institutional review board-approved retrospective study included all benign concordant MRI-guided biopsies performed between January 1, 2010, and May 1, 2018. The following was collected from the electronic medical record: patient and lesion characteristics, short-interval follow-up MRI recommendation, communication to referring physician, follow-up imaging, repeat biopsies, biopsy outcome, and patient insurance status. Compliance with recommendations was defined as follow-up MRI within 9 months of biopsy. RESULTS Among 98 patients, there were 107 lesions with benign concordant MRI-guided biopsy results that met study criteria. After excluding 7 patients who underwent subsequent mastectomy, 50/91 (54.9%) patients were recommended short-interval follow-up MRI. Of these, 33/50 (66.0%) had a short-interval follow-up MRI. Direct communication of the short-interval follow-up recommendation was documented in the biopsy report for 4/50 (8%) patients. Subsequent MRI was available for 77/107 (72%) lesions at a median of 29 months following MRI-guided biopsy (range, 3-96 months). Subsequent mammography was available for 21/30 (70%) remaining lesions at a median of 47 months following MRI-guided biopsy (range, 23-88 months). There were two repeat biopsies, with one subsequent malignancy, resulting in a false-negative rate of 0.9% (1/107). CONCLUSION When short-interval follow-up MRI was recommended following benign concordant MRI-guided breast biopsy, compliance was 66.0%. Lack of communication of the recommendation may at least partially explain the low compliance. The low false-negative rate (0.9%) suggests routine short-interval follow-up MRI may be unnecessary following benign concordant MRI-guided biopsy.
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Affiliation(s)
- Shruthi Ram
- Rhode Island Hospital, Department of Diagnostic Imaging, Providence, RI
- Alpert Medical School of Brown University, Providence, RI
| | | | - Grayson L Baird
- Rhode Island Hospital, Department of Diagnostic Imaging, Providence, RI
- Alpert Medical School of Brown University, Providence, RI
| | - Ana P Lourenco
- Rhode Island Hospital, Department of Diagnostic Imaging, Providence, RI
- Alpert Medical School of Brown University, Providence, RI
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7
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Meucci R, Pistolese Chiara A, Perretta T, Vanni G, Portarena I, Manenti G, Ryan Colleen P, Castrignanò A, Di Stefano C, Ferrari D, Lamacchia F, Pellicciaro M, Materazzo M, Buonomo Oreste C. MR imaging-guided vacuum assisted breast biopsy: Radiological-pathological correlation and underestimation rate in pre-surgical assessment. Eur J Radiol Open 2020; 7:100244. [PMID: 32715029 PMCID: PMC7369605 DOI: 10.1016/j.ejro.2020.100244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/25/2020] [Accepted: 07/01/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Magnetic Resonance(MR) guided percutaneous procedures(MRgVABB) have been developed and largely employed to reduce the need of surgical biopsies for suspicious lesions which can be detected only by MR(MR-only lesion). The present study aims to investigate correlation between imaging, histological features of MRgVABB and surgical specimens of MR-only lesions. METHODS We retrospectively enrolled 56 patients with a total of 61 lesions. Each finding was defined as Mass-Enhancement(ME) or Non-ME(NME) and classified according to BI-RADS. MRgVABB and surgical data were collected. Concordance between MR, MRgVABB and open biopsy was calculated. Underestimation Rate(UR) of MRgVABB with surgery was obtained. RESULTS B2 and B5b lesions were statistically associated with NME and ME, respectively. No statistical association was found to B3 nor to B5a with radiological features. UR was 10 %; underestimated lesions were strongly associated with the presence of a ME on MR imaging. Moreover, B3 lesions are associated with higher UR. CONCLUSION Radiological features should influence patient management aiming to construct a correct diagnostic and therapeutic plan. When MR is prescribed for breast cancer staging for ME-MR-only lesions, we suggest surgical open biopsy instead of MRgVABB when upfront surgery is the treatment of choice.
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Affiliation(s)
- Rosaria Meucci
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Adriana Pistolese Chiara
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Tommaso Perretta
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Gianluca Vanni
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Ilaria Portarena
- Medical Oncology Unit, Department of Systems Medicine, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Guglielmo Manenti
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Patricia Ryan Colleen
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Antonella Castrignanò
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Carla Di Stefano
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Donatella Ferrari
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Feliciana Lamacchia
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
| | - Claudio Buonomo Oreste
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata(PTV) University, Viale Oxford 81, 00133, Rome, Italy
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8
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Needle Heating During Interventional Magnetic Resonance Imaging at 1.5- and 3.0-T Field Strengths. Invest Radiol 2020; 55:396-404. [DOI: 10.1097/rli.0000000000000649] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Bick U, Trimboli RM, Athanasiou A, Balleyguier C, Baltzer PAT, Bernathova M, Borbély K, Brkljacic B, Carbonaro LA, Clauser P, Cassano E, Colin C, Esen G, Evans A, Fallenberg EM, Fuchsjaeger MH, Gilbert FJ, Helbich TH, Heywang-Köbrunner SH, Herranz M, Kinkel K, Kilburn-Toppin F, Kuhl CK, Lesaru M, Lobbes MBI, Mann RM, Martincich L, Panizza P, Pediconi F, Pijnappel RM, Pinker K, Schiaffino S, Sella T, Thomassin-Naggara I, Tardivon A, Ongeval CV, Wallis MG, Zackrisson S, Forrai G, Herrero JC, Sardanelli F. Image-guided breast biopsy and localisation: recommendations for information to women and referring physicians by the European Society of Breast Imaging. Insights Imaging 2020; 11:12. [PMID: 32025985 PMCID: PMC7002629 DOI: 10.1186/s13244-019-0803-x] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/10/2019] [Indexed: 12/13/2022] Open
Abstract
We summarise here the information to be provided to women and referring physicians about percutaneous breast biopsy and lesion localisation under imaging guidance. After explaining why a preoperative diagnosis with a percutaneous biopsy is preferred to surgical biopsy, we illustrate the criteria used by radiologists for choosing the most appropriate combination of device type for sampling and imaging technique for guidance. Then, we describe the commonly used devices, from fine-needle sampling to tissue biopsy with larger needles, namely core needle biopsy and vacuum-assisted biopsy, and how mammography, digital breast tomosynthesis, ultrasound, or magnetic resonance imaging work for targeting the lesion for sampling or localisation. The differences among the techniques available for localisation (carbon marking, metallic wire, radiotracer injection, radioactive seed, and magnetic seed localisation) are illustrated. Type and rate of possible complications are described and the issue of concomitant antiplatelet or anticoagulant therapy is also addressed. The importance of pathological-radiological correlation is highlighted: when evaluating the results of any needle sampling, the radiologist must check the concordance between the cytology/pathology report of the sample and the radiological appearance of the biopsied lesion. We recommend that special attention is paid to a proper and tactful approach when communicating to the woman the need for tissue sampling as well as the possibility of cancer diagnosis, repeat tissue sampling, and or even surgery when tissue sampling shows a lesion with uncertain malignant potential (also referred to as "high-risk" or B3 lesions). Finally, seven frequently asked questions are answered.
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Affiliation(s)
- Ulrich Bick
- Clinic of Radiology, Charité Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Rubina M Trimboli
- PhD Course in Integrative Biomedical Research, Department of Biomedical Science for Health, Università degli Studi di Milano, Via Mangiagalli, 31, 20133, Milan, Italy
| | - Alexandra Athanasiou
- Breast Imaging Department, MITERA Hospital, 6, Erithrou Stavrou Str. 151 23 Marousi, Athens, Greece
| | - Corinne Balleyguier
- Department of Radiology, Gustave-Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Pascal A T Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Wien, Austria
| | - Maria Bernathova
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Wien, Austria
| | | | - Boris Brkljacic
- Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Luca A Carbonaro
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Paola Clauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Wien, Austria
| | - Enrico Cassano
- Breast Imaging Division, European Institute of Oncology, Milan, Italy
| | - Catherine Colin
- Radiology Unit, Hospices Civils de Lyon, Centre Hospitalo-Universitaire Femme Mère Enfant, 59 Boulevard Pinel, 69 677, Bron Cedex, France
| | - Gul Esen
- School of Medicine, Department of Radiology, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Andrew Evans
- Dundee Cancer Centre, Clinical Research Centre, Ninewells Hospital and Medical School, Tom McDonald Avenue, Dundee, UK
| | - Eva M Fallenberg
- Diagnostic and Interventional Breast Imaging, Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Michael H Fuchsjaeger
- Division of General Radiology, Department of Radiology, Medical University Graz, Auenbruggerplatz 9, 8036, Graz, Austria
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills road, Cambridge, CB2 0QQ, UK
| | - Thomas H Helbich
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Wien, Austria
| | | | - Michel Herranz
- CyclotronUnit, GALARIA-SERGAS, Nuclear Medicine Department and Molecular ImagingGroup, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
| | - Karen Kinkel
- Institut de Radiologie, Clinique des Grangettes, Chemin des Grangettes 7, 1224 Chêne-Bougeries, Genève, Switzerland
| | - Fleur Kilburn-Toppin
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills road, Cambridge, CB2 0QQ, UK
| | - Christiane K Kuhl
- University Hospital of Aachen, Rheinisch-Westfälische Technische Hochschule, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Mihai Lesaru
- Radiology and Imaging Laboratory, Fundeni Institute, Bucharest, Romania
| | - Marc B I Lobbes
- Department of Radiology, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, PO Box 5500, 6130 MB, Sittard-Geleen, The Netherlands
| | - Ritse M Mann
- Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Laura Martincich
- Unit of Radiodiagnostics ASL AT, Via Conte Verde 125, 14100, Asti, Italy
| | - Pietro Panizza
- Breast Imaging Unit, Scientific Institute (IRCCS) Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy
| | - Federica Pediconi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Ruud M Pijnappel
- Department of Imaging, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Katja Pinker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Wien, Austria.,Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th Street, New York, NY, 10065, USA
| | - Simone Schiaffino
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Tamar Sella
- Department of Diagnostic Imaging, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Isabelle Thomassin-Naggara
- Department of Radiology, Sorbonne Université, APHP, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France
| | - Anne Tardivon
- Department of Radiology, Institut Curie, Paris, France
| | - Chantal Van Ongeval
- Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Matthew G Wallis
- Cambridge Breast Unit and NIHR Biomedical Research Unit, Box 97, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Sophia Zackrisson
- Diagnostic Radiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Skåne University Hospital Malmö, SE-205 02, Malmö, Sweden
| | - Gabor Forrai
- Department of Radiology, Duna Medical Center, Budapest, Hungary
| | | | - Francesco Sardanelli
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. .,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy.
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10
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Surveillance Imaging After MRI-Guided Benign Breast Biopsies. J Am Coll Radiol 2019; 16:936-939. [PMID: 30745039 DOI: 10.1016/j.jacr.2018.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/29/2018] [Accepted: 12/02/2018] [Indexed: 11/22/2022]
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11
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Schoub PK. Understanding indications and defining guidelines for breast magnetic resonance imaging. SA J Radiol 2018; 22:1353. [PMID: 31754513 PMCID: PMC6837823 DOI: 10.4102/sajr.v22i2.1353] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/07/2018] [Indexed: 12/29/2022] Open
Abstract
Magnetic resonance imaging (MRI) of the breast is the most sensitive imaging modality for detecting cancer. With improved scan resolution and correctly applied clinical indications, the specificity of breast MRI has markedly improved in recent years. Current literature indicates an overall sensitivity for breast MRI of 98% - 100% and specificity of 88%. By comparison, the sensitivity and specificity for mammography is in the region of 71% and 98%, respectively. In particular, the very high negative predictive value (NPV) of breast MRI, which approaches 100%, is hugely useful in establishing absence of disease. Furthermore, the ability to accurately delineate viable cancer by way of combining both morphological and functional (contrast enhancement) capabilities means that MRI is the best tool we have in terms of local cancer staging and identifying residual or recurrent disease. The high NPV also means that breast MRI is uniquely capable of ruling out cancer or high-grade ductal carcinoma in situ in appropriate circumstances. I hope that the following guidelines that are based on those of the American College of Radiology and the European Society of Breast Imaging in addition to multiple review articles will provide some assistance to radiologists in terms of the correct indications for breast MRI. There are few formal guidelines in South Africa for the usage of breast MRI. In fact, there is a general paucity of guidelines in the international radiology world. The role of breast MRI in high-risk screening and identification of the primary in occult breast cancer is universally accepted. Thereafter, there is little consensus. By using some general guidelines, and bringing MRI into the discussion of multidisciplinary breast cancer management, good clinical practice and consistent decision-making can be established.
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Affiliation(s)
- Peter K Schoub
- Department of Radiology, Parklane Radiology, Johannesburg, South Africa
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Radiologic-Pathologic Correlation for Benign Results After MRI-Guided Breast Biopsy. AJR Am J Roentgenol 2017; 209:442-453. [PMID: 28537753 DOI: 10.2214/ajr.16.17048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The majority of MRI-guided breast biopsies yield benign pathology. The purpose of this article is to provide a comprehensive overview of benign pathologic entities commonly encountered at MRI-guided breast biopsy. CONCLUSION Proper radiologic-pathologic correlation is an integral component of MRI-guided breast biopsy. Familiarity with the spectrum of MRI findings and key histopathologic features of common benign entities will enhance the radiologist's confidence in determining concordance and lead to improved patient management recommendations.
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