Title

Radiologic-Pathologic Discordance and Outcome After MRI-Guided Vacuum-Assisted Biopsy

UMMS Affiliation

Department of Radiology

Date

1-1-2017

Document Type

Article

Disciplines

Neoplasms | Oncology | Pathology | Radiology

Abstract

OBJECTIVE: The purpose of this study was to determine the rate, characteristics, and outcomes of discordant MRI-guided vacuum-assisted biopsy (VAB) in women with suspected breast cancer.

MATERIALS AND METHODS: This retrospective study reviewed 1314 MRI-guided VABs performed in 1211 women between 2007 and 2013 and yielded 25 discordant results in 24 women. MRI characteristics; BI-RADS assessments; whether the lesion was missed, partially sampled, or excised at biopsy; and biopsy and surgical pathology results were reviewed. Statistical analyses were performed using Fisher exact and Mann-Whitney U tests.

RESULTS: Among 1314 lesions that underwent MRI-guided VAB, 25 results were discordant (1.9%; 95% CI, 1.2-2.8%), and nine lesions with discordant results (36.0%, 95% CI, 18.5-56.9%) were malignant at surgical excision (three invasive ductal carcinoma and six ductal carcinoma in situ). There was no significant association between malignancy and lesion type, size, enhancement pattern, BI-RADS assessment, or clinical indication. Forty-four percent (11/25) of discordant lesions were missed, 48.0% (12/25) were partially sampled, and 8.0% (2/25) appeared to have been excised. Of the nine malignant lesions, 44.4% (4/9) discordant malignant lesions were missed, 44.4% (4/9) were partially sampled, and 11.1% (1/9) appeared to have been excised. Lesion sizes and types were similar in the missed and partially excised groups.

CONCLUSION: The potential for false-negative results at MRI-guided VAB underscores the importance of radiologic-histologic correlation and imaging review after biopsy. Rebiopsy or excision in discordant cases is therefore recommended.

Rights and Permissions

Citation: AJR Am J Roentgenol. 2017 Jan;208(1):W17-W22. Epub 2016 Oct 27. Link to article on publisher's site

Comments

At the time of article submission, Adrienne Newburg was not yet affiliated with the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

Keywords

MRI, breast cancer, discordance, vacuum-assisted biopsy

PubMed ID

27786559