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MR Guided Breast Biopsy

Coupled with the latest breast MRI technology and our experienced team of radiologists and technologists, we are now able to offer the complete solution for breast MRI and MR guided breast biopsy providing our community with the opportunity of having both their imaging and biopsy needs met.

Utilizing our Suros ATEC* system, we can provide high resolution of images of the breast with extensive anatomic coverage of the breast, axilla and chest wall. Utilizing our bilateral breast coil, which is designed to take advantage of our 8 Channel MRI system with an integrated system for:

  • Breast immobilization
  • Localization of suspicious lesions
  • Accurate guidance of MR compatible instruments
  • Both medial and lateral access for MR guided breast biopsy

The ATEC* system gives radiologists and surgeons the ability to optimize excellence of care by offering women a more compassionate breast biopsy option.

What is MR-Guided Breast Biopsy?

Lumps or abnormalities in the breast are often detected by imaging studies including mammography, ultrasound or magnetic resonance imaging (MRI). However, it is not always possible to tell from these imaging tests whether a growth in the breast is benign or cancerous.

A breast biopsy involves removing some cells—either surgically or in a less invasive procedure involving a hollow needle—from the suspicious area in the breast and examining them under a microscope to determine a diagnosis. The tissue removed during a biopsy ranges from a tiny amount to the entire area of abnormal tissue.

In MR-guided breast biopsy, magnetic resonance imaging is used to help guide the radiologist’s instruments to the suspicious area. The procedure is less invasive than surgical biopsy, requires only a local anesthetic, leaves little or no scarring, and can be performed in less than an hour.

What are some common uses of the procedure?

Image-guided biopsy is used when the abnormal area in the breast is too small to be felt, making it difficult for the physician to target the lesion by feeling (palpation). X-ray-guided (also called stereotactic) and ultrasound-guided breast biopsy procedures are ruled out if an abnormality is not clear with mammography or ultrasound scanning. When an abnormality is only visible with MRI, the physician may choose to perform an MR-guided breast biopsy.

MR-guidance is used to assist physicians in obtaining tissue samples from the breast in one or more of four different biopsy procedures: a fine needle aspiration (FNA), core needle (CN), vacuum-assisted (VABB) and wire localization followed by surgical removal or excision.

The fine needle aspiration is performed by inserting a small needle into the breast through the skin to the site of the abnormality to collect a small sample of cells. The small size of the needle in this procedure has several drawbacks: it requires a very precise approach, does not allow a marker clip to be left behind in the breast identifying the area of the abnormality, and cannot always distinguish between invasive breast cancer and in situ disease. For this reason, MR-guided fine needle aspiration is rarely performed.

The core needle biopsy uses a slightly larger needle, called an automated needle, to withdraw small cylinders or cores of tissue from the abnormal area of the breast. In this procedure, the needle is inserted three to five times to obtain samples. Because this procedure removes a larger amount of tissue, it can be more useful for determining treatment options if the analysis shows that the cells are cancerous.

In a vacuum-assisted biopsy (VABB), vacuum pressure is used to help pull tissue into the needle without having to withdraw the probe after each sampling, as is necessary with the core needle method. The samples from VABB are usually larger than with core needle biopsy. We use this procedure.

MRI also plays a role in some surgical biopsies through a procedure called wire localization. A surgical biopsy involves removing part of (incisional biopsy) or all of (excisional biopsy) the abnormal tissue for examination. A physician may use MR to help insert a wire through a hollow needle into the suspicious area of the breast, especially when the lump in the breast is too small to be felt. The surgeon then uses the wire as a guide to the area to be surgically biopsied.

How should I prepare for the procedure?

Although MR-guided breast biopsy is minimally invasive, there is a risk of bleeding whenever the skin is penetrated. For this reason, if you are taking aspirin or a blood thinner your physician may advise you to stop three days before the procedure. You may want to have a relative or friend come with you to lend support and also to drive you home after your procedure.

There are other precautions that should be taken related to the use of magnetic resonance imaging. You may be asked to provide a urine sample for a pregnancy test prior to your MRI exam. Because the risks to a fetus are unknown, pregnant women should not have an MRI exam unless the potential benefit from the MRI is determined to outweigh the potential risks.

The radiologist should also know about any serious health problems. If your physician plans to use a contrast material with the MRI, the staff should know about any known allergies. Finally, there are important guidelines for patients to follow prior to undergoing MR imaging.

To download instructions please click Exam Preparations

For more information go to Radiologyinfo.org