Ms. Liu is a 37 year-old female with presenting for MRI-guided biopsy of her right breast. Recent MRI performed on 11/04/2016 demonstrated an area of non-mass enhancement in the right lateral breast. On subtraction images, the previously identified area of non-mass enhancement is seen in the right lateral breast. Of note, there are now multiple additional areas of heterogenous non-mass enhancement seen in the right breast; all of which favor a finding of benign parenchymal breast tissue. However, given that the original finding is re-identified on today's examination, a decision to go forward with the MRI-guided biopsy was made. PROCEDURE:Coordinates of the central portion of the biopsy target were determined on the monitor. The approach was from lateral to medial direction. Overlying skin was cleansed with chlorhexidine and superficial and deep anesthesia were obtained with lidocaine. A 9-gauge introducer with stylet was advanced to the target lesion. Subsequent MR images confirmed satisfactory position of the tip of the introducer prior to the biopsy. A 9-gauge needle was then advanced to the target lesion and biopsy was performed using a Suros vacuum assisted device. A total of 5 cores were obtained and they were sent to Pathology with an accompanying history sheet.Post procedural MR images show no hematoma at the biopsy site. An ATEC clip was placed into the center of the target.Following the removal of the grid, pressure was held at the biopsy site until bleeding subsided. The skin wound was closed with a Steri-Strip and pressure bandage and ice pack were applied to the biopsy site.Specimen radiograph was obtained for documentation. No calcifications were seen in the specimen radiograph.The patient tolerated this procedure well and underwent a right unilateral mammogram CC and ML views to locate the percutaneously placed clip. The clip is placed in the right lateral breast with no evidence of any complications due to the procedure. The patient tolerated this procedure well and left the radiology suite in stable condition. The MR procedure was performed by Dr. Sheth.
Successful MR guided core needle biopsy of the non-mass enhancement in the right lateral breast with clip placement. Pathology is pending.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.