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Tissue compression is not necessary for needle-localized lesion identification.

Abstract

BACKGROUND: Tissue compression to enhance lesion visibility on radiography of needle-localized breast biopsy specimens is widely used. We hypothesized that compression is not necessary for detection of lesions on specimen radiography. METHODS: Forty-nine consecutive patients underwent needle-localization biopsies of 59 mammographic targets. All specimens were radiographed without and with compression. The films were later independently reviewed and compared with preoperative mammograms by 2 surgeons and a breast-imaging radiologist. The primary end point was identification of mammographic targets in noncompressed specimen radiographs. RESULTS: Twenty-nine targets were masses, 36 contained calcifications, and 14 contained previously placed clips. All mammographically localized lesions were identified on noncompressed views. Overall concordance for the 2 images was 100% for all 3 reviewers and 98% among reviewers. CONCLUSIONS: Tissue compression before specimen radiography is not routinely necessary for target lesion identification.

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BibTeXRIS

Jane E Méndez, Deborah ter Meulen, James Padussis, Deborah Richard-Kowalski, Manuel Raagas, Sidney Pollack, Daniel O'Connor, Michael D Stone. 2005. Tissue compression is not necessary for needle-localized lesion identification.. https://doi.org/10.1016/j.amjsurg.2005.06.016

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Targeting difficult accessible breast lesions: MRI-guided needle localization using a freehand technique in a 3.0 T closed bore magnet.

PURPOSE: To report the accuracy of magnetic resonance imaging (MRI)-guided needle localization for diagnosis of MRI detected suspicious breast lesions located in difficult accessible regions of the breast, using the freehand method in a 3.0 T closed bore magnet. MATERIALS AND METHODS: In five patients with five MRI-only breast lesions underwent MRI-guided needle localization for histopathologic evaluation of the lesions. All interventional procedures were performed in a 3.0 T MRI system with the patient in prone position and by using a dedicated phased array breast coil. MRI-guided needle localizations were performed by using a freehand technique. In our study, the high-resolution scan allowed preprocedural localization of all lesions without use of contrast enhancement. In all cases contrast-enhanced MRI was performed after insertion of the wire to confirm the tip of the wire in direct contact with the enhancing lesion. RESULTS: Needle localizations were performed in five patients. Histopathologic evaluation of tissue after surgery excision biopsy revealed one lymph node, three invasive ductal carcinoma and one ductal carcinoma in situ. Lesion size varied from 6 to 30 mm. Mean duration time was 25 min. No complications occurred during the intervention method. In the patient with the benign lesion control MRI of the breast after 6 months confirmed lesion removal. CONCLUSIONS: MRI-guided needle localization by using a freehand technique in a 3.0 T closed bore magnet is a safe and accurate method for diagnosis of difficult accessible breast lesions only visible on MRI.

Biopsy, Needle↗