The role of MRI in the management of patients with a histological diagnosis of B3 breast lesion after vacuum-assisted biopsy: A case report and a brief review of the literature.

This case report and literature review examine the role of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in managing of breast lesions diagnosed as B3 after vacuum-assisted biopsy (VAB). A 48-year-old female patient with first-degree family history of breast cancer, whose mammography, ultrasound, and magnetic resonance imaging (MRI) showed an area of parenchymal distortion in the left upper outer quadrant (UOQ), underwent a VAB, which revealed a B3 lesion (radial scar with atypia). She subsequently underwent a vacuum-assisted excision (VAE), and a 4-month follow-up MRI showed residual enhancement in the treated area; after a multidisciplinary discussion, she underwent surgery, which confirmed the complex sclerosing lesion (CLS) with atypia. The authors highlight the importance of MRI's high negative predictive value in excluding malignancy, especially in conjunction with VAE, which allows for more comprehensive tissue sampling and reduces the need for surgical excision in B3 cases. The multidisciplinary approach and correlation of radiological and pathological findings are emphasized as crucial for optimal patient management.