Contrast-enhanced mammography-guided biopsy: initial experience

Paulina Neira-Vallejos, Departamento de Radiología, Centro de la Mama de Clínica MEDS La Dehesa, Santiago, Chile
María C. Vial, Departamento de Radiología, Centro de la Mama de Clínica MEDS La Dehesa, Santiago, Chile
Carolina Behnke, Departamento de Radiología, Centro de la Mama de Clínica MEDS La Dehesa, Santiago, Chile
Rodrigo Herrmann, Departamento de Radiología, Centro de la Mama de Clínica MEDS La Dehesa, Santiago, Chile

Introduction: Contrast-enhanced mammography (CEM) is a breast imaging modality that shows suspicious lesions that enhance with iodinated contrast, similar to MRI, detecting lesions that may not be represented in conventional modalities such as mammography and breast ultrasound. Objective: To evaluate feasibility and performance of CEM-guided percutaneous biopsy and compare these results with those of magnetic resonance imaging (MRI)-guided biopsy. Material and methods: A prospective observational study of lesions diagnosed as suspicious by CEM or breast MRI, that underwent CEM biopsy. We recorded patient and lesion characteristics, procedural details, histopathological results and procedural success. Results: A total of 43 patients, with a median age of 50 years, were referred for CEM biopsy during the study period. The lesion type was mainly non-enhancing (72%) with a median size of 12 mm. The biopsy success rate was 40/43 (93%). In more than half of the cases, the procedure was based on the diagnosed finding on MRI, without prior CEM biopsy. The median procedure time was 17 minutes. The malignancy rate was 15%, and the high-risk lesion rate was 30%, with only one case of underdiagnosis (2.5%). Conclusion: CEM biopsy is a safe and reliable procedure as an alternative to MRI-guided biopsy.

Keywords: Percutaneous biopsies. Contrast-enhanced mammography. Breast neoplasia. Breast MRI.