Skip to main content
Log in

Magnetic resonance imaging-guided biopsy of mammographically and clinically occult breast lesions

  • Original Articles
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Breast magnetic resonance imaging (MRI) is a very sensitive technique for detection of breast cancer. We report on MRI-guided needle localization for biopsy of abnormalities seen only on MRI.

Methods

A retrospective review was performed of 231 patients with invasive breast cancer or ductal carcinoma-in-situ who had MRI as part of their evaluation and treatment at the University of Pennsylvania between 1992 and 1998. Clinical, radiological, and pathologic data were examined.

Results

MRI needle localization was performed in 41 (18%) patients. MRI needle localization was required for a finding of a mammographically or clinically occult lesion in 31 patients, better MRI definition of tumor in 5 patients, and surgeon’s choice in 5 patients. In all cases, MRI localization and excisional biopsy were successfully completed. Nineteen of 31 patients were found to have additional mammographically and clinically occult tumors. There were 12 (29%) falsepositive MRI scans.

Conclusions

MRI has a high sensitivity for detection of breast cancer; additional mammographically and clinically occult sites of tumor are detected in approximately 1 (15%) of 7 breast cancer patients. These otherwise occult sites of disease can be appropriately biopsied with MRI needle-localization techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Kurtz J, Jacquemier J, Amalric R, et al. Breast-conserving therapy for macroscopically multiple cancers.Ann Surg 1990;212:38–44.

    Article  PubMed  CAS  Google Scholar 

  2. Kurtz J. Factors influencing the risk of local recurrence in the breast.Eur J Cancer 1992;28:660–6.

    Article  PubMed  CAS  Google Scholar 

  3. Holland R, Veling S, Mravunac M, Hendriks J. Histologic multifocality of Tis, T1–2 breast carcinomas. Implications for clinical trials of breast-conserving surgery.Cancer 1985;56:970–90.

    Article  Google Scholar 

  4. Anastassiades O, Iakovou E, Stavridou N, Gogas J, Karameris A. Multicentricity in breast cancer. A study of 366 cases.Am J Clin Pathol 1993;99:238–43.

    PubMed  CAS  Google Scholar 

  5. Schwartz G, Patchesfsky A, Feig S, Shaber G, Schwartz A. Multicentricity of non-palpable breast cancer.Cancer 1980;45:2913–6.

    Article  PubMed  CAS  Google Scholar 

  6. Vaidya J, Vyas J, Chinoy R, Merchant N, Sharma O, Mittra I. Multicentricity of breast cancer: whole-organ analysis and clinical implications.Br J Cancer 1996;74:820–4.

    PubMed  CAS  Google Scholar 

  7. Gilles R, Guinebretiere J, Lucidarme O, et al. Nonpalpable breast tumors: diagnosis with contrast-enhanced subtraction dynamic MR imaging.Radiology 1994;191:625–31.

    PubMed  CAS  Google Scholar 

  8. Harms S, Flaming D, Hesley K, et al. MR imaging of the breast with rotating delivery of excitation off resonance: clinical experience with pathologic correlation.Radiology 1993;187:493–501.

    PubMed  CAS  Google Scholar 

  9. Orel S, Schnall M, Powell C, et al. Staging of suspected breast cancer effect of MR imaging and MR-guided biopsy.Radiology 1995;196:115–22.

    PubMed  CAS  Google Scholar 

  10. Fischer U, Kopka L, Grabbe E. Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach.Radiology 1999;213:881–8.

    PubMed  CAS  Google Scholar 

  11. Drew P, Chatterjee S, Turnbull L, et al. Dynamic contrast enhanced magnetic resonance imaging of the breast is superior to triple assessment for the pre-operative detection of multifocal breast cancer.Ann Surg Oncol 1999;6:599–603.

    Article  PubMed  CAS  Google Scholar 

  12. Boetes C, Mus R, Holland R, et al. Breast tumors: comparative accuracy of MR imaging relative to mammography and US for demonstrating extent.Radiology 1995;197:743–7.

    PubMed  CAS  Google Scholar 

  13. Kuhl C, Elevelt A, Leutner C, Gieseke J, Pakos E, Schild H. Interventional breast MR imaging: clinical use of a stereotatic localization and biopsy device.Radiology 1997;204:667–75.

    PubMed  CAS  Google Scholar 

  14. Orel S, Schnall M, LiVolsi V, Troupin R. Suspicious breast lesions: MR imaging with radiologic-pathologic correlation.Radiology 1994;190:485–93.

    PubMed  CAS  Google Scholar 

  15. Piccoli CW. Contrast enhanced breast MRI: factors affecting sensitivity and specificity.Eur Radiol 1997;7(Suppl 5):281–8.

    Article  PubMed  Google Scholar 

  16. Park C, Mitsumori M, Nixon A, et al. Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer: influence of margin status and systemic therapy on local recurrence.J Clin Oncol 2000;18:1668–75.

    PubMed  CAS  Google Scholar 

  17. Harris J, Recht A, Amalric R, et al. Time course and prognosis of local recurrence following primary radiation therapy for early breast cancer.J Clin Oncol 1984;2:37–41.

    PubMed  CAS  Google Scholar 

  18. Fowble B, Solin L, Schultz D, Goodman R. Ten year results of conservative surgery and irradiation for stage I and II breast cancer.Int J Radiat Oncol Biol Phys 1991;21:269–77.

    PubMed  CAS  Google Scholar 

  19. Fisher E, Sass R, Fisher B, Gregorio R, Brown R, Wicherham L. Pathologic findings from the National Surgical Adjuvant Breast Project (protocol 6). II. Relation of local breast recurrence to multicentricity.Cancer 1986;57:1717–24.

    Article  PubMed  CAS  Google Scholar 

  20. Lagios M, Richards V, Rose M, Yee E. Segmental mastectomy without radiotherapy. Short-term follow-up.Cancer 1983;52:2173–9.

    Article  PubMed  CAS  Google Scholar 

  21. Orel S, Weinstein S, Schnall M, et al. Breast MR imaging in patients with axillary node metastases and unknown primary malignancy.Radiology 1999;212:543–9.

    PubMed  CAS  Google Scholar 

  22. Olson J, Morris E, Van Zee K, Linehan D, Borgen P. Magnetic resonance imaging facilitates breast conservation for occult breast cancer.Ann Surg Oncol 2000;7:411–5.

    Article  PubMed  Google Scholar 

  23. Esserman L, Hylton N, Yassa L, Barclay J, Frankel S, Sickles E. Utility of magnetic resonance imaging in the management of breast cancer: evidence for improved preoperative staging.J Clin Oncol 1999;17:110–9.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Brian J. Czerniecki MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bedrosian, I., Schlencker, J., Spitz, F.R. et al. Magnetic resonance imaging-guided biopsy of mammographically and clinically occult breast lesions. Annals of Surgical Oncology 9, 457–461 (2002). https://doi.org/10.1007/BF02557268

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02557268

Key Words

Navigation