Chloé Dratwa1, Aurélie Jalaguier-Coudray2, Jeanne Thomassin-Piana3, Julie Gonin4, Jocelyne Chopier5, Martine Antoine4, Isabelle Trop6, Emile Darai7,8, Isabelle Thomassin-Naggara5,8,9. 1. Department of Radiology, AP-HP, Hôpital Tenon, 75020, Paris, France. chloedratwa@gmail.com. 2. Department of Radiology, Institut Paoli-Calmettes, 13009, Marseille, France. 3. Biopathology Department, Institut Paoli-Calmettes, 13009, Marseille, France. 4. Department of Pathology, AP-HP, Hôpital Tenon, 75020, Paris, France. 5. Department of Radiology, AP-HP, Hôpital Tenon, 75020, Paris, France. 6. Department of Radiology, Hôtel-Dieu de Montréal, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada, H2W 1T8. 7. Department of Gynaecology and Obstetrics, AP-HP, Hôpital Tenon, 75020, Paris, France. 8. UPMC Univ Paris 06, IUC, Sorbonne Universités, 75005, Paris, France. 9. INSERM, UMR970, Equipe 2, Imagerie de l'angiogenèse, 75005, Paris, France.
Abstract
PURPOSE: To identify pathological features for sample analysis of magnetic resonance imaging-guided vaccum-assisted breast biopsy (MRIgVaBB) to optimize radio pathological correlation and identify discordant benign result. MATERIAL AND METHODS: Databases of two centres were queried to identify MRIgVaBB performed between January 2009 and February 2013. A cohort of 197 women (mean age: 54.5 years (24-77)) with 208 lesions was identified. We retrospectively analyzed all prebiopsy MRI examinations according to the new BI-RADS lexicon, and all biopsy samples to describe the lesion of interest, its interface with the surrounding breast tissue and other associated features. RESULTS: The malignancy rate was 26.0 % (54/208) with an underestimation rate of 15.67 % (5/32). A visible interface at pathology between a biopsied lesion and the surrounding breast tissue was more frequently identified in mass enhancement compared to NME or focus (p = 0.0003). Regional NME was correlated with a high degree of fibrosis (p = 0.001) and the presence of PASH (p = 0.0007). Linear or segmental NME was correlated with the presence of periductal mastitis (p = 0.0003). CONCLUSION: The description of a visible interface between the target lesion and the surrounding tissue is crucial to confirm the correct targeting of an MR mass or a NME. KEY POINTS: • Pathological interface correlated with magnetic resonance mass and focal non-mass enhancement (NME). • Linear or segmental NME correlated with mastitis or ductal carcinoma in situ. • Fibrosis and pseudoangiomatous stromal hyperplasia (PASH) are correlated with regional NME.
PURPOSE: To identify pathological features for sample analysis of magnetic resonance imaging-guided vaccum-assisted breast biopsy (MRIgVaBB) to optimize radio pathological correlation and identify discordant benign result. MATERIAL AND METHODS: Databases of two centres were queried to identify MRIgVaBB performed between January 2009 and February 2013. A cohort of 197 women (mean age: 54.5 years (24-77)) with 208 lesions was identified. We retrospectively analyzed all prebiopsy MRI examinations according to the new BI-RADS lexicon, and all biopsy samples to describe the lesion of interest, its interface with the surrounding breast tissue and other associated features. RESULTS: The malignancy rate was 26.0 % (54/208) with an underestimation rate of 15.67 % (5/32). A visible interface at pathology between a biopsied lesion and the surrounding breast tissue was more frequently identified in mass enhancement compared to NME or focus (p = 0.0003). Regional NME was correlated with a high degree of fibrosis (p = 0.001) and the presence of PASH (p = 0.0007). Linear or segmental NME was correlated with the presence of periductal mastitis (p = 0.0003). CONCLUSION: The description of a visible interface between the target lesion and the surrounding tissue is crucial to confirm the correct targeting of an MR mass or a NME. KEY POINTS: • Pathological interface correlated with magnetic resonance mass and focal non-mass enhancement (NME). • Linear or segmental NME correlated with mastitis or ductal carcinoma in situ. • Fibrosis and pseudoangiomatous stromal hyperplasia (PASH) are correlated with regional NME.
Entities:
Keywords:
Biopsy; Breast; Magnetic Resonance Imaging; Neoplasms; Pathology
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