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Complete Excision of the MRI Target Lesion at MRI-Guided Vacuum-Assisted Biopsy of Breast Cancer

Jung-Min Lee1, Jennifer B. Kaplan1, Melissa P. Murray2 and Laura Liberman1

1 Breast Imaging Section, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10065.
2 Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY.


Figure 1
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  		Fig. 1A —54-year-old woman who, after recent lumpectomy of left breast for ductal carcinoma in situ (DCIS) with microinvasion, underwent bilateral breast MRI to assess for additional ipsilateral or contralateral cancer. Sagittal T1-weighted image of right breast after injection of IV contrast material shows linear clumped enhancement measuring 0.7 cm in central right breast.

 

Figure 2
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  		Fig. 1B —54-year-old woman who, after recent lumpectomy of left breast for ductal carcinoma in situ (DCIS) with microinvasion, underwent bilateral breast MRI to assess for additional ipsilateral or contralateral cancer. Sagittal T1-weighted image of right breast after IV injection of gadolinium and MRI-guided vacuum-assisted biopsy shows air at and anterior to biopsy site. Target lesion is no longer identified. Vacuum-assisted biopsy yielded DCIS. Residual DCIS was present at surgery.

 

Figure 3
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  		Fig. 2A —74-year-old woman with recently diagnosed invasive ductal carcinoma in right breast who underwent bilateral breast MRI to assess extent of disease. Sagittal T1-weighted image of left breast after injection of IV gadolinium shows irregular enhancing mass in upper inner quadrant measuring 1 cm (arrow), for which biopsy was suggested.

 

Figure 4
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  		Fig. 2B —74-year-old woman with recently diagnosed invasive ductal carcinoma in right breast who underwent bilateral breast MRI to assess extent of disease. Sagittal T1-weighted image of left breast obtained after injection of IV gadolinium and completion of tissue acquisition at MRI-guided 9-gauge vacuum-assisted biopsy shows air and hematoma obscuring biopsy site. Enhancing lesion is no longer evident. Ductal carcinoma in situ (DCIS) was found at histologic analysis of vacuum-assisted biopsy specimens. Surgery confirmed residual DCIS.

 

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