Sona Ajit Chikarmane MD, Presenter: Nothing to Disclose

Catherine Streeto Giess MD, Abstract Co-Author: Nothing to Disclose

Robyn L. Birdwell MD, Abstract Co-Author: Nothing to Disclose

MRI-guided breast procedures are a safe and increasingly routine method for evaluating suspicious MRI-detected breast lesions. Despite this, MRI-guided procedures can be challenging, with relatively high biopsy cancellation rates ranging from 8-17%. Our objective is to 1) review problematic factors in breast MRI procedures and 2) provide strategies for optimizing success and subsequent lesion management.

1) Provide a brief review of breast MRI procedure indications and technical considerations, including set-up strategies (i.e. positioning, grid pressure) 2) Discuss optimizing timing of breast MRI procedures to minimize potential hormonal influences, particularly in pre-menopausal women 3) Address reasons for and strategies to prevent procedure cancellations 4) Demonstrate challenging lesion locations, particularly posterior & medial lesions, and discuss the role of supplemental tools for biopsy (i.e. use of targeted ultrasound and mammography localization after clip placement with MRI guidance rather than MRI core biopsy) 5) Review the importance of pathology correlation (no specimen, discordant or non-specific results) and follow-up strategies of benign biopsies (six-month follow-up and when to re-biopsy or surgically excise) 6) Display challenging cases and review potential mishaps, strategies for success, and management  

http://abstract.rsna.org/uploads/2014/14008130/14008130_hd3x.pdf

Chikarmane, S, Giess, C, Birdwell, R, Challenges, Precautions and Mishaps in Breast MRI Procedures and Outcomes: Strategies to Optimize Success.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14008130.html