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Imaging-Concordant Benign MRI-Guided Vacuum-Assisted Breast Biopsy May Not Warrant MRI Follow-Up.
AJR Am J Roentgenol. 2017 Apr; 208(4):916-922.AA

Abstract

OBJECTIVE

The follow-up of breast lesions with imaging-concordant benign histopathology results on MRI-guided vacuum-assisted biopsy (VAB) is not currently standardized. We determined the false omission rate of breast MRI-guided VAB with benign histopathology (negative results) to assess whether breast MRI follow-up is needed.

MATERIALS AND METHODS

The medical records of patients who underwent 9-gauge breast MRI-guided VAB during 2007-2012 were reviewed retrospectively. Lesions with imaging-concordant benign histopathology results from MRI-guided VAB and surgery or 2 years or more of imaging follow-up were included. The false omission rate (1 - negative predictive value; [number of false-negative results / number of negative results]) of MRI-guided VAB was calculated.

RESULTS

One hundred sixty-nine lesions were included, and 135 had only imaging follow-up (mammography follow-up: range, 17-107 months [median, 52 months]; MRI follow-up: range, 5-95 months [median, 35 months]). Of the 135 lesions with only imaging follow-up, 48 had mammography only (range, 26-86 months; median, 52 months), and 87 had mammography (range, 17-107 months; median, 52 months) and MRI (range, 5-95 months; median, 35 months). Thirty-four lesions had surgical correlation, and there were no cases of imaging-surgical discordance. Four malignancies were later diagnosed in the same breast in which MRI-guided VAB had been performed. One (0.6%) malignancy was invasive ductal carcinoma at 1 cm from the MRI-guided VAB site; it was mammographically detected 24 months after MRI-guided VAB. The other three malignancies developed 4 cm or more from the site of MRI-guided VAB: one ductal carcinoma in situ (DCIS) detected on mammography 12 months after MRI-guided VAB, one DCIS detected on MRI 24 months after MRI-guided VAB, and one Paget disease lesion detected at physical examination 32 months after MRI-guided VAB.

CONCLUSION

Breast MRI-guided VAB has a low false omission rate. MRI follow-up of lesions with concordant benign MRI-guided VAB histopathology results may not be warranted.

Authors+Show Affiliations

1 Department of Diagnostic Radiology, Section of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.1 Department of Diagnostic Radiology, Section of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.2 Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX.1 Department of Diagnostic Radiology, Section of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.1 Department of Diagnostic Radiology, Section of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.1 Department of Diagnostic Radiology, Section of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.3 Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.1 Department of Diagnostic Radiology, Section of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28140609

Citation

Huang, Monica L., et al. "Imaging-Concordant Benign MRI-Guided Vacuum-Assisted Breast Biopsy May Not Warrant MRI Follow-Up." AJR. American Journal of Roentgenology, vol. 208, no. 4, 2017, pp. 916-922.
Huang ML, Speer M, Dogan BE, et al. Imaging-Concordant Benign MRI-Guided Vacuum-Assisted Breast Biopsy May Not Warrant MRI Follow-Up. AJR Am J Roentgenol. 2017;208(4):916-922.
Huang, M. L., Speer, M., Dogan, B. E., Rauch, G. M., Candelaria, R. P., Adrada, B. E., Hess, K. R., & Yang, W. T. (2017). Imaging-Concordant Benign MRI-Guided Vacuum-Assisted Breast Biopsy May Not Warrant MRI Follow-Up. AJR. American Journal of Roentgenology, 208(4), 916-922. https://doi.org/10.2214/AJR.16.16576
Huang ML, et al. Imaging-Concordant Benign MRI-Guided Vacuum-Assisted Breast Biopsy May Not Warrant MRI Follow-Up. AJR Am J Roentgenol. 2017;208(4):916-922. PubMed PMID: 28140609.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Imaging-Concordant Benign MRI-Guided Vacuum-Assisted Breast Biopsy May Not Warrant MRI Follow-Up. AU - Huang,Monica L, AU - Speer,Megan, AU - Dogan,Basak E, AU - Rauch,Gaiane M, AU - Candelaria,Rosalind P, AU - Adrada,Beatriz E, AU - Hess,Kenneth R, AU - Yang,Wei T, Y1 - 2017/01/31/ PY - 2017/2/1/pubmed PY - 2017/4/11/medline PY - 2017/2/1/entrez KW - MRI-guided KW - benign KW - breast KW - imaging-concordant KW - vacuum-assisted breast biopsy SP - 916 EP - 922 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 208 IS - 4 N2 - OBJECTIVE: The follow-up of breast lesions with imaging-concordant benign histopathology results on MRI-guided vacuum-assisted biopsy (VAB) is not currently standardized. We determined the false omission rate of breast MRI-guided VAB with benign histopathology (negative results) to assess whether breast MRI follow-up is needed. MATERIALS AND METHODS: The medical records of patients who underwent 9-gauge breast MRI-guided VAB during 2007-2012 were reviewed retrospectively. Lesions with imaging-concordant benign histopathology results from MRI-guided VAB and surgery or 2 years or more of imaging follow-up were included. The false omission rate (1 - negative predictive value; [number of false-negative results / number of negative results]) of MRI-guided VAB was calculated. RESULTS: One hundred sixty-nine lesions were included, and 135 had only imaging follow-up (mammography follow-up: range, 17-107 months [median, 52 months]; MRI follow-up: range, 5-95 months [median, 35 months]). Of the 135 lesions with only imaging follow-up, 48 had mammography only (range, 26-86 months; median, 52 months), and 87 had mammography (range, 17-107 months; median, 52 months) and MRI (range, 5-95 months; median, 35 months). Thirty-four lesions had surgical correlation, and there were no cases of imaging-surgical discordance. Four malignancies were later diagnosed in the same breast in which MRI-guided VAB had been performed. One (0.6%) malignancy was invasive ductal carcinoma at 1 cm from the MRI-guided VAB site; it was mammographically detected 24 months after MRI-guided VAB. The other three malignancies developed 4 cm or more from the site of MRI-guided VAB: one ductal carcinoma in situ (DCIS) detected on mammography 12 months after MRI-guided VAB, one DCIS detected on MRI 24 months after MRI-guided VAB, and one Paget disease lesion detected at physical examination 32 months after MRI-guided VAB. CONCLUSION: Breast MRI-guided VAB has a low false omission rate. MRI follow-up of lesions with concordant benign MRI-guided VAB histopathology results may not be warranted. SN - 1546-3141 UR - https://www.unboundmedicine.com/medline/citation/28140609/Imaging_Concordant_Benign_MRI_Guided_Vacuum_Assisted_Breast_Biopsy_May_Not_Warrant_MRI_Follow_Up_ L2 - https://www.ajronline.org/doi/10.2214/AJR.16.16576 DB - PRIME DP - Unbound Medicine ER -