Authors' objectives: MRI-guided VABB is a breast biopsy technique used for percutaneous histologic tissue acquisition of non palpable breast lesions, only detected by MRI and having neither sonographic nor mammographic correlates. This minimally invasive needle biopsy technique reduces the need for open surgical breast biopsy in patients with benign lesions and allows for optimal preoperative work-up and surgical planning through definitive diagnosis in patients with breast cancer. Our objective was to evaluate technical success rate, safety and diagnostic effectiveness of MRI-guided VABB and determine its clinical indications for use. Specific practice and facility requirements for reimbursement in France were equally assessed.

Authors' recommendations: MRI-guided VABB appears to be technically feasible, safe, and effective in characterizing breast lesions based on the findings of five prospective studies. The average success rate was 95%. In approximately one quarter of lesions (26%), cancer was found at MRI-guided VABB. High-risk lesions were found in 4% of lesions and benign concordant lesions in over two-thirds (68%). Overall, surgical histology findings revealed 95% concordance and 5% underestimation. For lesions yielding atypical ductal hyperplasia at biopsy, the frequency of cancer at surgery ranged from 25 to 67%. No incident of cancer was reported at MRI follow-up (range: 3-24 months) for patients with benign concordant lesions, not accounting for an approximate lost to follow-up rate of 12%. In France, the incidence of cancer at the MRI follow-up is estimated between 1-2% (expert opinion). Frequent complications include discomfort and neck pain related to patient positioning and immobility required throughout the procedure, followed by non complicated hematoma and bleeding at the puncture site.

Project Status: Completed

Year Published: 2011

URL for published report: http://www.has-sante.fr/portail/upload/docs/application/pdf/2011-12/rapport_macrobiopsie_mammaire_irm.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: Haute Autorité de Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: has.seap.secretariat@has-sante.fr

Contact Email: has.seap.secretariat@has-sante.fr