MRI-guided Breast Biopsy Confirmed by X-ray

"Contrast-enhanced MRI of the breast is becoming increasingly useful in patients with lesions that cannot be detected with other techniques,” said Basak Erguvan-Dogan, M.D., radiologist in breast imaging at the University of Texas M.D. Anderson Cancer Center (Houston, TX; USA). "However, it is hard to confirm removal of the targeted lesion because the abnormality does not enhance after being removed from the breast,” she said.

Currently, patients who have MRI-guided needle localization and excision of abnormal tissue may be asked to have follow-up breast MRI; if the lesion has not been effectively removed, another biopsy procedure will need to be performed. "By taking x-rays of the lesion specimen, then slicing it up and taking additional x-rays, we can determine if the lesion has been removed or if additional tissue needs to be excised while the patient is still in the operating room,” Dr. Erguvan-Dogan said.

Whole-specimen and sliced-specimen radiography was performed in 10 patients, and x-raying the tumor as a whole and in slices was shown to be helpful, said Dr. Erguvan-Dogan. "In all five malignant cases, sliced specimen radiographs showed the lesion in question, helped the pathologist correctly identify the lesion while the patient was still in the operating room, and helped the surgeon obtain negative surgical margins,” said Dr. Erguvan-Dogan. Furthermore, "whole specimen radiography is able to correctly locate fractured biopsy needle localization wires, which may be removed before the patient left the operating room.”

Specimen radiography is regularly used in some institutions after mammographically and sonographically guided needle localization and excision. However, specimen radiography following MRI-guided needle localization has not been previously studied, according to Dr. Erguvan-Dogan.

The study was published in the August 2006 issue of the American Journal of Roentgenology.



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