Pitfalls of Dynamic Contrast Enhanced MR Mammography (DCE-MRM) in Evaluation of Post-Biopsy Suspicious Breast Lesions

Abstract
Background: Breast MRI examination after diagnosis of breast cancer has been established to assess true extension of the disease. Therefore, it is important to evaluate any potential effect of biopsy on imaging characteristics.
Aim of the Study: This study aimed to evaluate efficacy of contrast enhanced magnetic resonance mammography (DCE-MRM) in evaluation of post-biopsy breast lesions.
Patients and Methods: Sixty-five female patients with suspicious breast lesions were included in this study. Dynamic contrast enhanced MR mammography (DCE-MRM) were performed to all patients pre and post biopsy, histopathological correlation was done as a golden slandered.
Results: There was over-estimation in 3 patients that were categorized as BIRADS3 based on pre-biopsy DCE-MRM and upgraded to BIRADS4 in post-biopsy examination, how-ever their pathology were negative for malignant cells. There was under-estimation in 2 patients that were categorized as BIRADS5 based on pre-biopsy DCE-MRM and downgraded to BIRADS4 in post biopsy examination, their pathology were positive for malignant cells. Number of BIRAD4 cases in-creased in post-biopsy DCE-MRM by 5 lesions. The pre-biopsy DCE-MRM accuracy was 91.8% and the post-biopsy was 85.7%. p-value <0.00001 which was statistically highly significant.
Conclusion: Breast biopsy can cause uneven changes with possibility of alter the appearance on DCE-MRM. Chang-es in imaging characteristics can lead to inaccuracy of nature and extension of the tumor, which could have significant impact on treatment planning.