FIGURE 1.
Flowchart shows the study population.
FIGURE 2.
MRI-guided breast biopsy with hematoma as a sequela. (A) Target lesion in the lower outer quadrant. (B) Biopsy needle in target position. (C) After vacuum-assisted biopsy, a hematoma has formed. Within it, a recognizable susceptibility artifact is due to the marker.
FIGURE 3.
Illustration of the measurements. (A) In blue, the distance from the lesion to the nipple. A circle was drawn around the target lesion to capture the proportion of the surrounding mammary gland. These measurements were taken after multiplanar reconstruction (MPR) of the dynamic T1 subtraction sequence. (B) Access route and biopsy angle. (C) Perpendicular distance from the pectoralis major muscle to the lesion in T1-weighted with spectral attenuated inversion recovery (SPAIR) sequence.
FIGURE 4.
Histological findings of breast biopsies.
ADH = atypical ductal hyperplasia; DCIS; ductal carcinoma in situ; FEA = flat epithelial cell atypia; ILC = invasive lobular carcinoma; LCIS = lobular carcinoma in situ; LIN = lobular intraepithelial neoplasia; NST = non-special type
TABLE 1.
Univariate analysis for relatively larger hematoma with patient demographics and lesion characteristics
| Survey of breast biopsies | |||||||
|---|---|---|---|---|---|---|---|
| Parameter | All (n=252) | Relatively smaller hematoma (n = 200) | Relatively larger hematoma (n = 52) | P Value | |||
| Age (y) | 51.96 | ±11.69 | 53.09 | ±11.09 | 47.63 | ±12.984 | 0.002* |
| Procedure time (min) | 41.83 | ±13.39 | 42.58 | ±13.80 | 38.96 | ±11.324 | 0.072 |
| Right biopsy side | 117 | 46% | 90 | 45% | 27 | 52% | 0.436 |
| Number of samples | 12.08 | ± 4 | 11.81 | ±4.08 | 13.1 | ±3.533 | 0.243 |
| Biopsy system | 0.035* | ||||||
| VABB | 228 | 90% | 177 | 88.5% | 51 | 98% | |
| Spirotome | 24 | 10% | 23 | 11.5% | 1 | 2% | |
| LAE | 171 | 68% | 133 | 67% | 38 | 73% | 0.408 |
| Lesion size (mm) | 11.2 | ±6.612 | 11.27 | ±6.55 | 10.94 | ±6.89 | 0.425 |
| Distance LN in RBV | 0.079 | ± 0.05 | 0.07 | ± 0.04 | 0.11 | ±0.04 | 0.001* |
| Access path length in RBV | 0.055 | ± 0.046 | 0.05 | ± 0.03 | 0.08 | ±0.07 | 0.001* |
| PDPectLesion in RBV | 0.065 | ± 0.036 | 0.06 | ± 0.04 | 0.07 | ± 0.04 | 0.143 |
| Biopsy angle (degree) | 90.79 | ± 10.4 | 90.93 | ± 9.55 | 90.27 | ± 13.26 | 0.443 |
| Pathological findings | 0.831 | ||||||
| Benignity | 159 | 63% | 125 | 63% | 34 | 65% | |
| highrisk lesions | 36 | 14% | 28 | 14% | 8 | 15% | |
| Malignancy | 57 | 23% | 47 | 24% | 10 | 19% | |
| Pretreatment | 65 | 26% | 55 | 28% | 10 | 19% | 0.286 |
| Lesion location | 0.399 | ||||||
| Upper inner q | 47 | 19% | 34 | 17% | 13 | 25% | |
| Upper outer q | 84 | 33% | 64 | 32% | 20 | 38% | |
| Lower inner q | 24 | 10% | 21 | 11% | 3 | 6% | |
| Lower outer q | 72 | 29% | 61 | 31% | 11 | 21% | |
| Areolar | 25 | 10% | 20 | 10% | 5 | 10% | |
| Proportion of mammary gland | 0.215 | ||||||
| 0–25% | 105 | 42% | 85 | 43% | 20 | 38% | |
| 25–50% | 48 | 19% | 37 | 19% | 11 | 21% | |
| 50–75% | 47 | 19% | 37 | 19% | 10 | 19% | |
| 75–100% | 52 | 21% | 41 | 21% | 11 | 21% | |
1 Unless stated otherwise, data are number of biopsies. ± standard deviations. X2 (R X 2), Fisher’s exact test and Mann-Whitney-U-Test were used to calculate the statistical difference between groups of categorical, dichotomous, and continuous variables, respectively. Data are mean ± standard deviation.
1 LAE = local anesthesia mixed with epinephrine; LN= lesion to nipple; min = minutes; mm = millimeters; PDPectLesion = perpendicular distance from the pectoralis major muscle to the lesion; Pretreatment = affected breast pretreated; RBV = in Relation to Breast Volume; VABB = vacuum-assisted breast biopsy; q = quadrant; Y = Year
TABLE 2.
Results of multivariate logistic regression analysis for relatively larger hematoma
| B | S.E. | Wald test | df | P value | Odds ratio | 95% CI | ||
|---|---|---|---|---|---|---|---|---|
| Variable | - | + | ||||||
| Age (y) | -0.031 | 0.160 | 3.927 | 1 | 0.048* | 0.969 | 0.94 | 1 |
| Biopsy system | 2.468 | 1.11 | 4.947 | 1 | 0.026* | 11.798 | 1.341 | 103.811 |
| Distance LN in RBV | 9.501 | 3.538 | 7.214 | 1 | 0.007* | 13379 | 13.037 | 13.7 × 10^6 |
| Access path length in RBV | 7.622 | 3.49 | 4.77 | 1 | 0.029* | 2043 | 2.186 | 1.9 × 10^6 |
| Procedure time (min) | -0.025 | 0.015 | 2.759 | 1 | 0.097 | 0.975 | 0.947 | 1.005 |