MRI-guided vacuum assisted breast biopsy – How I do it

Contrast-enhanced magnetic resonance imaging (MRI) of the breast is the most sensitive tool in breast cancer detection. The MRI-only visible lesions must be biopsied before any surgical treatment is planned. This technical note details every step entailed in performing the MRI-guided vacuum-assisted breast biopsy (VABB) procedure as well as the technical requirements needed to start this service. The preprocedural workup includes a comprehensive evaluation, coagulation parameter assessment, and obtaining informed consent. The procedural steps involve lesion localization using dynamic post-contrast T1-weighted images, calculating coordinates with a fiducial marker as a reference point, and using targeting software for precision. The biopsy is performed with the patient in a prone position and includes skin preparation, local anesthesia, and ensuring accurate needle placement for sampling. The VABB system enables multiple, directional, and contiguous sampling, ensuring accurate sampling and reducing chances of undersampling. It can completely remove smaller lesions. This method ensures effective targeting and sampling of breast lesions with minimal complications.