Advanced MRI-Guided Biopsy Offers New Edge In Early Breast Cancer Detection

With breast cancer cases rising sharply in India and studies indicating a significant proportion still going undetected in routine screening, clinicians are underlining the urgent need for advanced diagnostic tools that can identify the disease at its earliest and most treatable stages.

Against this backdrop, Apollo Hospitals Group has joined the bandwagon of medical institutions, such as Max Healthcare and Medanta, in adopting highly sophisticated MRI-guided Vacuum-Assisted Breast Biopsy (VABB)—a minimally invasive, precision-driven diagnostic technique that enables radiologists to accurately sample suspicious breast tissue, often through a single small skin incision.

According to radiologists, what sets VABB apart is its ability to retrieve larger and more representative tissue samples in a single procedure. “Using a vacuum-powered device, multiple samples can be obtained through one needle insertion, reducing procedure time, discomfort, and the likelihood of repeat biopsies.

“This becomes especially valuable when we are dealing with small, deep-seated, or difficult-to-localise lesions—say, like in those breasts having dense tissues,” said Dr. Jyoti Arora, Consultant and Lead, Department of Breast Radiology, Apollo Athenaa Women’s Cancer Centre, a unit of Apollo Hospitals Enterprise, announcing the launch of the technology at the Centre.

On the need for the MRI-guided technology, Dr. Arora pointed out that studies indicate that 10–20 per cent of breast cancers can be missed on mammography, a figure that rises substantially in women with dense breast tissue. These “hidden” cancers often grow silently, without lumps or early symptoms, remaining invisible on conventional imaging such as mammography and ultrasound.

“The challenge is particularly acute in India, where younger women are increasingly being diagnosed with aggressive forms of breast cancer, often nearly a decade earlier than their Western counterparts.”

She added that MRI is frequently used for women at high risk of breast cancer and those with dense breast tissue, where mammography and ultrasound are less effective.

While MRI has superior sensitivity and excels at detecting subtle or biologically aggressive lesions, detection alone is not sufficient. “When a lesion is seen only on MRI, it cannot be reliably biopsied using ultrasound or mammography guidance. This is where MRI-guided VABB plays a pivotal role,” Dr. Geeta Kadayaprath, Lead, Breast Surgical Oncology and Oncoplastic Surgery added. “It allows precise targeting of such lesions for histopathological confirmation without resorting to surgical biopsy.”

Talking from a patient’s perspective and the challenges faced by clinicians, Dr. Jyoti Wadhwa, Lead—Medical and Precision Oncology, said the advantages of the technology are substantial. The procedure is performed under local anaesthesia, recovery is quick, scarring is minimal, and anxiety is significantly reduced due to timely and reliable results, she added.

Dr. Arora cited the case of a 70-year-old woman who presented with bloody nipple discharge, a known warning sign. Her mammography and ultrasound findings were normal. “MRI, however, revealed a suspicious area. MRI-guided VABB confirmed Stage 0 ductal carcinoma in situ (DCIS)—a micro-stage cancer that would have remained undetected and progressed without intervention. Prompt surgical management was possible only because of MRI-guided VABB,” she said.

Such early-stage detection—often at Stage 0 or Stage 1, when the disease is small, asymptomatic, and highly treatable—can dramatically alter outcomes.

Pitching for MRI-guided VABB, Priyanjai, in her thirties, who has a family history of cancer, recalled that an unusual growth was detected in her right breast during a precautionary scan, following which she was advised an MRI-guided mammogram. The procedure confirmed the lesion to be benign.

“It was a minimally invasive procedure and the results came within three to four days. The waiting period was harder than the test itself, especially for my parents who had already seen one daughter undergo cancer treatment. I would strongly urge anyone with a similar finding not to delay such investigations, as early and precise diagnosis reduces risk and gives peace of mind,” she said.

While experts acknowledge challenges such as higher costs and technical complexity compared with ultrasound-guided procedures, they asserted that MRI-guided VABB represents a critical step forward in strengthening breast cancer diagnostics.

Later, speaking to Health Outlook, Dr. Arora underscored the urgent need to bust persistent myths surrounding breast cancer, one of the main reasons for delayed diagnosis and treatment. Many women, she said, continue to believe that “this cannot happen to me,” or that a biopsy can cause cancer to spread—both of which are medically unfounded fears.

Attributing rising cases to changing and sedentary lifestyles, alcohol, and smoking, she noted that breast cancer is often wrongly perceived as a disease affecting only older women or those with a family history, and that breast pain is frequently assumed to be a defining symptom. “In reality, breast cancer can affect anyone, including men. Genetics may play a role, but the absence of family history does not offer immunity,” she explained.

Dr. Arora emphasised that early detection through routine screening such as mammography, along with self-breast examination and timely clinical evaluation, remains critical. “Most breast lumps are benign. In many cases, a simple examination lasting just a few minutes can bring clarity and reassurance,” she said, while stressing the importance of awareness to remove the stigma surrounding the disease.

Dr. Preetha Reddy, Executive Vice Chairperson, Apollo Hospitals Group, said the launch of MRI-guided VABB aims to close gaps and reduce uncertainty. “It strengthens the entire breast diagnostic pathway with greater precision, speed, and clinical confidence, enabling timely and minimally invasive intervention. Or say, it’s about telling the patients that better options are available,” she said.

Doctors say breast cancer remains the most common cancer among women globally, and its burden in India is rising at an alarming pace. According to the ICMR–National Centre for Disease Informatics and Research (NCDIR), breast cancer accounts for 27–28 per cent of all female cancers in India. Projections estimate a 170.5 per cent rise in new cases and a 200.5 per cent increase in deaths by 2050, with a worrying shift towards younger age groups.