MRI-guided breast biopsy – initial outcomes from three years' experience at University Hospitals of Coventry and Warwickshire, UK

Purpose Aim of this retrospective study was to reflect on the initial experience with magnetic resonance imaging (MRI) guided breast biopsy (MRGBx) along with the surgical outcomes. Methods and materials Thirty-two patients who had suspicious or indeterminate lesions were listed for MRGBx from July 2011 to October 2014. In three patients, lesions were not found at the time of biopsy (these patients are on follow up), and in two patients two lesions were seen. Hence the total number of MRGBx performed was 31 in 29 patients. Vacuum assisted biopsy was performed and post biopsy marker clip was deployed followed by check mammograms. Data was retrospectively analysed to show MRI morphology, histology findings and surgical outcomes. Results There were 15 mass and 16 non-mass lesions on MRGBx. Of these, 80% mass, and 43.75% non-mass lesions were found malignant. Two cases of stromal fibrosis/B1 presented as non-mass lesions. The MRGBx histology outcome in 31 biopsies was: two were B1, ten B2, two B3, three B4, seven B5a and seven B5b. Both patients with B1 (stromal fibrosis) histopathology outcome are on surveillance. MRGBx altered management plan in 16 patients out of 29. Two patients had clinically suspicious lesions that did not require surgery, eight had mastectomy instead of wide local excision; and six patients who were normal on conventional-imaging required surgical intervention. Conclusion MRI guided biopsies influence decision making in patients with breast lesions.