Magnetic Resonance Imaging–guided Biopsy of the Breast: A Ten-Year Experience

Introduction: Magnetic resonance imaging (MRI) is an effective modality for high-risk patient screening, local staging, and disease monitoring in breast malignancies.There is an increasing demand for MRI-guided biopsy of lesions that are occult on mammography or ultrasound.This study summarises our 10-year experience with the procedure.Technical challenges, as well as tips and tricks to achieve procedural success are discussed.Methods: A total of 37 consecutive cases of MRI-guided vacuum-assisted breast biopsies performed at a single centre between August 2012 and August 2023 were retrospectively reviewed.Targets were localised using 1.5-T MRI systems with a dedicated breast coil and localisation device.Biopsies were performed using 10-gauge or 9-gauge needles.Imaging characteristics, histopathological results, and subsequent management for all biopsied lesions were recorded.Results: The mean age of patients was 51.6 years.Technical success was achieved in 35 out of 37 cases (94.6%).In 27 cases (77.1%), the biopsied breast was placed in the ipsilateral coil, and in eight cases (22.9%) it was placed in the contralateral coil for optimal imaging and biopsy access.Between 8 and 24 cuttings were taken for each target.Three cases (8.6%) developed biopsy site haematomas.Of the 35 successfully biopsied lesions, 11 (31.4%) were malignant.Among the malignant lesions, six (54.5%) presented as non-mass enhancement and five (45.5%) as mass enhancement.Four lesions (36.4%) showed restricted diffusion, while seven (63.6%) did not.Conclusion: MRI-guided vacuum-assisted biopsy of the breast is a safe and effective procedure in the hands of experienced interventionists.It is essential for the diagnosis and management of breast lesions occult on conventional imaging.