MRI guided breast biopsies dr. Marc B.I. Lobbes, MD, PhD, EBBI

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Presentation transcript:

MRI guided breast biopsies dr. Marc B.I. Lobbes, MD, PhD, EBBI Parkstad Mamma Symposium Heerlen – 17 mei 2019

’Second look’ / target echografie Results of studies vary: 22.6-82.1%, pooled rate 57.5% (95% CI 50.0-64.1%) More often succesfull for masses and/or malignancies However: (pooled) 12.2% of lesions not found is still malignant So: negative target US cannot rule out breast cancer Options: image fusion or additional breast tomosynthesis? Spick C, et al. Radiology 2014; 273: 401-409

Checklist prior to MRI guided biopsy All imaging available, including targeted ultrasound? Tolerate prolonged immobilization for 45-60 minutes Contra-indications: MRI, lesions location, anti-coagulants, breast implants L M Heywang-Köbrunner S, et al. Eur J Radiol 2009; 72: 289-294

Quality of breast MRI guided biopsy Use of a VAB system, minimal needle size 11 Gauge Minimum amount of samples is 24 or equal volume Marker placement is recommended, checked with mammography Minimum procedures 15, followed by at least 10 procedures annually Proper imaging / pathology correlation in MDT Heywang-Köbrunner S, et al. Eur J Radiol 2009; 72: 289-294

Quality of breast MRI guided biopsy Heywang-Köbrunner S, et al. Eur J Radiol 2009; 72: 289-294

Example case

Non visualisation of lesions during MRI guided biopsy Cancellation of procedure occurs in 8% (70/907 procedures) Influencing factors: BPE, breast density, lesions <1 cm In 58/70 cases with MRI follow-up: no cancers occured Cancer detection rate with any follow-up: 2% So: at least MRI follow-up is recommend (6 months) Brennan S, et al. Radiology 2011; 261: 92-99

Contact information dr. Marc B.I. Lobbes, MD, PhD, EBBI Maastricht UMC+, dep. Radiology and NM Per July 1st: Zuyderland Medical Center, dep. Radiology m.lobbes@zuyderland.nl