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Breast-nonmalignant
Procedures
MRI directed breast excision
Editor: Hind Nassar, M.D., Johns Hopkins Medical Institute (see Reviewers page)
Revised: 26 September 2012, last major update April 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
General
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● Widely used in US (AJR Am J Roentgenol 2008;191:332)
● MRI cannot verify that suspicious lesion is in specimen (unlike traditional radiography), because MRI requires IV injection of gadolinium and uptake into suspicious area, which cannot be done after specimen has been excised
Indications
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● Screening of high risk women for breast cancer (AJR Am J Roentgenol 2003;181:619, Cancer 2005;103:1898)
● Monitoring response to neoadjuvant chemotherapy (Radiology 2007;244:672)
● If uncertain diagnosis on mammography, ultrasound or clinically (AJR Am J Roentgenol 1999;173:1323)
● If lymph node metastases from unknown primary (Radiology 1999;212:543)
Clinical features
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● Low (87%) sensitivity for diagnosing mammographically detected microcalcifications (AJR Am J Roentgenol 2006;186:1723)
● Recommended to submit entire specimen for microscopic examination because usually no gross findings (Hum Pathol 2007;38:1754)
● Complete removal of MRI target does not ensure complete histologic excision of the cancer (AJR Am J Roentgenol 2008;191:1198)
● MRI guided vacuum-assisted biopsy may provide an alternative to surgery and MRI-guided needle biopsy (AJR Am J Roentgenol 2003;181:1283)
● May overestimate gross tumor size (Int J Clin Exp Pathol 2010;3:303)
Additional references
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End of Breast-nonmalignant > Procedures > MRI directed breast excision
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