MR-guided breast biopsy offered as surgical alternative

Tuesday, May 13, 2003

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JACKSONVILLE, Fla., May 13, 2003 — Radiologists at Mayo Clinic in Jacksonville are now performing breast biopsies guided by magnetic resonance (MR) imaging. "This is a new, much-needed, long-awaited technology," says Dr. Elizabeth DePeri, a Mayo Clinic radiologist who performed the clinic's first MR-guided breast biopsy.

Click on a link below to view interviews with Dr. Betty Mincey, Dr. Elizabeth DePeri and a patient about this procedure:

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MR-guided breast biopsies, like other image-guided breast biopsy procedures, are usually preferred alternatives to surgical biopsies. The imaging technique helps physicians place a needle into the suspect tissue and remove a sample. One type of needle used is called a core needle, which removes a small, cylindrical-shaped tissue sample. These percutaneous (through the skin) procedures leave minimal scarring and no deformity. They cost less than surgical biopsies, require only a topical anesthetic, can be performed in less than an hour and have virtually no potential complications.

In addition, core needle biopsy with a vacuum-assisted needle, which applies suction to draw out tissue, has proven to be as reliable as surgical biopsy. Mayo Clinic in Jacksonville is among the first sites in the country to do this type of MR-guided breast biopsy with the ATEC breast biopsy and excision system. This system, the only commercially available vacuum assisted biopsy device compatible with MR, makes vacuum assisted breast biopsy possible without leaving the MR suite.

Women with a family or personal history of breast cancer, those who've had previous breast surgery and those with dense breast tissue are often evaluated with MR to detect breast cancer. "Dense breast tissue looks white on a mammogram, and so does everything else we're looking for," DePeri says. "With MR, the density of the breast tissue doesn't matter at all, so we can detect cancers that are harder to find."

DePeri says before MR-guided breast biopsy was possible, MR may have revealed a suspect area of the breast that required a biopsy. However, that could not be accomplished without moving the patient to another area for biopsy or without going to surgery.

For a non-surgical biopsy, the woman would be taken to ultrasound or mammography, but the suspect lesion might not show up with either of those imaging techniques. This would require the skill of the radiologist to place an internal "tag" in the suspect area of the breast and a significant number of further imaging studies to locate the lesion. "So this really streamlines care for the patient quite a bit," DePeri says.

MR-guided breast biopsy can also help determine the course of treatment when breast cancer is diagnosed. "If the patient is going to the operating room to have a little lump removed and then going to get radiation and chemotherapy, you want to make sure you're not missing something else before treatment," DePeri explains. "That's one of the most common reasons for us to do MR. We do it on a lot of patients who've already been diagnosed with a breast cancer to make sure the rest of that breast and the other breast are free of cancer." For the patient to remain a candidate for breast-conserving lumpectomy, radiologists would take an MR-guided biopsy of additional suspect areas.

The ATEC system works in the presence of the magnetic field created by MR because it is pneumatically powered instead of electrically powered. MRI Devices Corporation created the surface coil that provides a smaller, breast-shaped magnetic field within the large tubular magnet of the MR machine. This surface coil has an opening in it so that radiologists can access the breast to insert the vacuum-assisted needle.

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