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Innovative strategies for minimizing hematoma risk in MRI-guided breast biopsies Cover

Innovative strategies for minimizing hematoma risk in MRI-guided breast biopsies

Open Access
|Jan 2025

Figures & Tables

FIGURE 1.

Flowchart shows the study population.
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.
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.
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
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

Univariate analysis for relatively larger hematoma with patient demographics and lesion characteristics

Survey of breast biopsies
ParameterAll (n=252)Relatively smaller hematoma (n = 200)Relatively larger hematoma (n = 52)P Value
Age (y)51.96±11.6953.09±11.0947.63±12.9840.002*
Procedure time (min)41.83±13.3942.58±13.8038.96±11.3240.072
Right biopsy side11746%9045%2752%0.436
Number of samples12.08± 411.81±4.0813.1±3.5330.243
Biopsy system 0.035*
  VABB22890%17788.5%5198%
  Spirotome2410%2311.5%12%
LAE17168%13367%3873%0.408
Lesion size (mm)11.2±6.61211.27±6.5510.94±6.890.425
Distance LN in RBV0.079± 0.050.07± 0.040.11±0.040.001*
Access path length in RBV0.055± 0.0460.05± 0.030.08±0.070.001*
PDPectLesion in RBV0.065± 0.0360.06± 0.040.07± 0.040.143
Biopsy angle (degree)90.79± 10.490.93± 9.5590.27± 13.260.443
Pathological findings 0.831
  Benignity15963%12563%3465%
  highrisk lesions3614%2814%815%
  Malignancy5723%4724%1019%
Pretreatment6526%5528%1019%0.286
Lesion location 0.399
  Upper inner q4719%3417%1325%
  Upper outer q8433%6432%2038%
  Lower inner q2410%2111%36%
  Lower outer q7229%6131%1121%
  Areolar2510%2010%510%
Proportion of mammary gland 0.215
  0–25%10542%8543%2038%
  25–50%4819%3719%1121%
  50–75%4719%3719%1019%
  75–100%5221%4121%1121%

Results of multivariate logistic regression analysis for relatively larger hematoma

BS.E.Wald testdfP valueOdds ratio95% CI
Variable -+
Age (y)-0.0310.1603.92710.048*0.9690.941
Biopsy system2.4681.114.94710.026*11.7981.341103.811
Distance LN in RBV9.5013.5387.21410.007*1337913.03713.7 × 10^6
Access path length in RBV7.6223.494.7710.029*20432.1861.9 × 10^6
Procedure time (min)-0.0250.0152.75910.0970.9750.9471.005
DOI: https://doi.org/10.2478/raon-2025-0004 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 91 - 99
Submitted on: Aug 27, 2024
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Accepted on: Nov 12, 2024
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Published on: Jan 22, 2025
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2025 Michael P Brönnimann, Matthew T McMurray, Johannes T Heverhagen, Andreas Christe, Corinne Wyss, Alan A Peters, Adrian T Huber, Florian Dammann, Verena C Obmann, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.