Cancelation of MRI Guided Breast Biopsies for Suspicious Breast Lesions Identified at 3.0 T MRI: Reasons, Rates, and Outcomes

Abstract

To determine the cancelation rate of magnetic resonance imaging (MRI)-guided procedures in suspicious breast lesions initially detected at 3.0 Tesla (T) MRI. With institutional review board approval, a Health Insurance Portability and Accountability Act-compliant retrospective review of 117 suspicious 3.0 T MRI-detected lesions in 101 patients scheduled to undergo MRI-guided procedures was performed; informed consent was waived. Patient information, imaging features, and outcome data were collected and compared among completed and canceled procedures using Fisher's exact test. MRI-guided breast biopsies were canceled in 13% (15/117) because of lesion nonvisualization, including three (20%) masses, one (1%) focus, and 11 (73%) areas of nonmasslike enhancement. Median lesion size was 1.1 cm. Sixty percent (9/15) of nonvisualized lesions were associated with minimal or mild background parenchymal enhancement at MRI. The nonvisualization rate was not associated with patient age, menopausal status, lesion type, size, breast density, or background parenchymal enhancement (P > .7 for each). No cancers were detected at original lesion sites in 14 (93%) patients undergoing follow-up imaging (n = 11) or mastectomy (n = 3) for cancer elsewhere; one (7%) was lost to follow-up. The MRI-guided breast biopsy cancelation rate from nonvisualization of suspicious lesions originally detected with 3.0 T MRI scanning was 13%, similar to rates reported for lesions detected at 1.0 and 1.5 T MRI. No cancers were detected on follow-up imaging. Canceling MRI-guided biopsies because of lesion nonvisualization is a reasonable approach if measures are taken to ensure lesion resolution at the time of biopsy and at imaging follow-up.