Magnetic Resonance Imaging-guided Breast Biopsies: Tips and Tricks

Abstract

As a robust imaging modality, magnetic resonance imaging (MRI) of the breast offers sensitivity that approaches 100% for invasive carcinoma and approaches 80%e90% for in situ carcinoma [1e4]. As with all breast imaging modalities, there is an overlap between benign and malignant features which necessitate biopsy [5,6]. Because many lesions identified on MRI will be occult on other imaging modalities, biopsy under MR (magnetic resonance) guidance is an integral part of any breast imaging program in today’s imaging paradigm (Figure 1). The instrumentation and basic methodology for MRI-guided biopsies performed at Memorial Sloan-Kettering Cancer Center (MSKCC) was previously reviewed [7]. With this methodology as a foundation, and based on the institution’s experience with over 2000 biopsies, we present 10 tips that we have found useful in performing this procedure safely, accurately, and efficiently.