Simple MR Guided Breast Biopsy Strategy: technique and radiological-pathological association

Abstract Background MRI is pivotal in breast imaging, encompassing staging, treatment monitoring, and lesion differentiation. While MRI boasts high sensitivity, specificity, and utility in detecting otherwise unseen lesions, challenges persist in accurately distinguishing benign from malignant findings. The study delves into MRI-guided breast biopsy outcomes and highlights the importance of radiologic-pathologic results. Methods This retrospective study analyzed 109 MRI-guided breast biopsies conducted on lesions identified between 2017 and 2023. the patients underwent biopsies for screening and diagnostic purposes. Biopsy procedures involved meticulous MRI guidance using a 1.5 Tesla system. Lesions were categorized based on location and BIRADS lexicon, with biopsy results spanning benign, suspicious, and malignant pathologies. Data collection encompassed a wide array of patient factors and pathology reports, meticulously reviewed by experienced radiologists, shedding light on the efficacy and outcomes of MRI-guided breast biopsies. Results The participants had a mean age of 45 ± 11 years. A significant association was found between the history of pregnancy and breast lesion enhancement. Patients with mass enhancement had a higher BIRADS B4b, B4c, and B5 classification rate, while those with non-mass enhancement were more commonly classified as BIRADS B3 and B4a. Histopathology diagnoses were significant in determining the presence of mass or non-mass lesions. The sensitivity and specificity of MRI for detecting malignancy were high for BIRADS categories 4c and 5 but may result in a higher number of false positives. Conclusions our research highlighted the significance of MRI in the diagnosis of breast cancer, particularly when used in conjunction with high-risk lesions as well as showed the need of sub-classifying BI-RADS-4 lesions to minimize the number of unnecessary biopsies. The results affirm the ongoing use of MRI-guided biopsy for the detection of breast cancer.