MRI-guided vacuum-assisted breast biopsy: experience of a single tertiary referral cancer centre and prospects for the future: Medical Oncology

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MRI-guided vacuum-assisted breast biopsy (VABB) is used for suspicious breast cancer (BC) lesions which are detectable only with MRI: because the high sensitivity but limited specificity of breast MRI it is a fundamental tool in breast imaging divisions. We analyse our experience of MRI-guided VABB and critically discuss the potentialities of diffusion-weighted imaging (DWI) and artificial intelligence (AI) in this matter. We retrospectively analysed a population of consecutive women underwent VABB at our tertiary referral BC centre from 01/2011 to 01/2019. Reference standard was histological diagnosis or at least 1-year negative follow-up. McNemar, Mann–Whitney and χ2 tests at 95% level of significance were used as statistical exams. 217 women (mean age = 52, 18–72 years) underwent MRI-guided VABB; 11 were excluded and 208 MRI-guided VABB lesions were performed: 34/208 invasive carcinomas, 32/208 DCIS, 8/208 LCIS, 3/208 high-risk lesions and 131/208 benign lesions were reported. Accuracy of MRI-guided VABB was 97%. The predictive features for malignancy were mass with irregular shape (OR 8.4; 95% CI 0.59–31.6), size of the lesion (OR 4.4; 95% CI 1.69–9.7) and mass with irregular/spiculated margins (OR 5.4; 95% CI 6.8–31.1). Six-month follow-up showed 4 false-negative cases (1.9%). Invasive BC showed a statistically significant higher hyperintense signal at DWI compared to benign lesions (p = 0.03). No major complications occurred. MR-guided VABB showed high accuracy. Benign-concordant lesions should be followed up with breast MRI in 6–12 months due to the risk of false-negative results. DWI and AI applications showed potential benefit as support tools for radiologists. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Original languageEnglish
JournalMed. Oncol.
Issue number5
Publication statusPublished - 2020


  • Artificial intelligence
  • Breast cancer
  • Breast imaging
  • Breast MRI
  • Diffusion-weighted imaging
  • Oncology
  • Radiology
  • Vacuum-assisted breast biopsy
  • gadolinium chelate
  • adult
  • aged
  • Article
  • artificial intelligence
  • atypical ductal hyperplasia
  • breast biopsy
  • breast cancer
  • breast carcinoma
  • breast discharge
  • breast fibrosis
  • breast tumor
  • cancer center
  • cancer diagnosis
  • diagnostic accuracy
  • diagnostic test accuracy study
  • diffusion weighted imaging
  • female
  • follow up
  • human
  • human tissue
  • intraductal carcinoma
  • invasive carcinoma
  • major clinical study
  • mammography
  • nuclear magnetic resonance imaging
  • predictive value
  • priority journal
  • retrospective study
  • sensitivity and specificity
  • tertiary care center
  • vacuum
  • adolescent
  • breast
  • diagnostic imaging
  • image guided biopsy
  • middle aged
  • pathology
  • very elderly
  • young adult
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Artificial Intelligence
  • Breast
  • Breast Neoplasms
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Image-Guided Biopsy
  • Magnetic Resonance Imaging
  • Middle Aged
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tertiary Care Centers
  • Vacuum
  • Young Adult


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