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CT-Guided Core Needle Biopsy of Breast Lesions Visible Only on MRI

Jeffrey B. Mendel1, Michelle Long1 and Priscilla J. Slanetz2

1 Department of Radiology, Caritas St. Elizabeth's Medical Center, 736 Cambridge St., Boston, MA 02135.
2 Department of Radiology, Boston Medical Center, Boston, MA.


Figure 1
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  		Fig. 1A —70-year-old woman with history of treated ipsilateral breast cancer and suspicious enhancement in lateral aspect of breast. Biopsy revealed intracystic papilloma. MR image shows suspicious lesion (arrowhead) and MRI skin marker (arrow). Posterior margin of biopsy grid is indicated by thin white line.

 

Figure 2
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  		Fig. 1B —70-year-old woman with history of treated ipsilateral breast cancer and suspicious enhancement in lateral aspect of breast. Biopsy revealed intracystic papilloma. CT image obtained immediately after MRI shows lesion (arrowhead) is close to MRI skin marker (arrow).

 

Figure 3
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  		Fig. 2A —45-year-old woman with suspicious enhancement adjacent to breast implant. Pathology revealed benign breast tissue. MR image of suspicious lesion (arrowhead) and retropectoral breast implant (asterisk). MR-guided core needle biopsy could not be performed safely because projected path of biopsy needle (dotted line) would likely have ruptured implant. This image is rotated for comparison with B.

 

Figure 4
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  		Fig. 2B —45-year-old woman with suspicious enhancement adjacent to breast implant. Pathology revealed benign breast tissue. CT image shows lesion (arrowhead) and retropectoral breast implant (asterisk) with minimally radiopaque obturator in place (arrow).

 

Figure 5
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  		Fig. 3A —54-year-old woman with suspicious enhancement adjacent to chest wall. Pathology revealed invasive ductal carcinoma and ductal carcinoma in situ. CT image shows lesion (arrowhead) with 25-gauge guide needle (arrow) in place.

 

Figure 6
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  		Fig. 3B —54-year-old woman with suspicious enhancement adjacent to chest wall. Pathology revealed invasive ductal carcinoma and ductal carcinoma in situ. After CT-guided placement of guide needle (arrow), lesion (arrowhead) is faintly visible on sonography.

 

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