A Case of Ductal Carcinoma in Situ Diagnosed and Treated with Magnetic Resonance Imaging-guided Breast Biopsy

Abstract

Magnetic resonance imaging (MRI) of the breast is the most sensitive modality for the detection of breast cancer among current clinical imaging modalities such as mammography (MMG) and ultrasonography (US). We have detected lesions that were observed as abnormalities only on MRI alone (MRI-only visible lesions). In Europe and the United States, MRI-guided vacuum-assisted breast biopsy (MRI-guided VAB) is commonly used for evaluating such lesions. In Japan, MRI-guided VAB was included in the medical insurance coverage in April 2018. Accordingly, our facility established a system that can perform MRI-guided biopsy. We report the findings of the first evaluated case. The patient was a 61-year-old woman. She presented with bloody nipple discharge and was referred to our hospital. MRI-guided biopsy was performed because no target lesion could be identified for stereotactic-guided or ultrasound-guided biopsy. The biopsy result indicated a ductal carcinoma in situ (DCIS). Subsequently, surgical treatment was performed, and the final pathological result was still DCIS. MRI-guided biopsy is an effective diagnostic tool when MRI-detected lesions are observed without any lesions detected on either ultrasound or stereotactic-guided biopsy.