Short interval follow-up after a benign concordant MR-guided vacuum assisted breast biopsy – is it worthwhile?

Abstract Objective To evaluate compliance with short-interval follow-up MRI after benign concordant MRI-guided breast biopsy. Methods This institutional review board-approved retrospective study included all benign concordant MRI-guided biopsies performed between January 1, 2010, and May 1, 2018. The following was collected from the electronic medical record: patient and lesion characteristics, short-interval follow-up MRI recommendation, communication to referring physician, follow-up imaging, repeat biopsies, biopsy outcome, and patient insurance status. Compliance with recommendations was defined as follow-up MRI within 9 months of biopsy. Results Among 98 patients, there were 107 lesions with benign concordant MRI-guided biopsy results that met study criteria. After excluding 7 patients who underwent subsequent mastectomy, 50/91 (54.9%) patients were recommended short-interval follow-up MRI. Of these, 33/50 (66.0%) had a short-interval follow-up MRI. Direct communication of the short-interval follow-up recommendation was documented in the biopsy report for 4/50 (8%) patients. Subsequent MRI was available for 77/107 (72%) lesions at a median of 29 months following MRI-guided biopsy (range, 3–96 months). Subsequent mammography was available for 21/30 (70%) remaining lesions at a median of 47 months following MRI-guided biopsy (range, 23–88 months). There were two repeat biopsies, with one subsequent malignancy, resulting in a false-negative rate of 0.9% (1/107). Conclusions When short-interval follow-up MRI was recommended following benign concordant MRI-guided breast biopsy, compliance was 66.0%. Lack of communication of the recommendation may at least partially explain the low compliance. The low false-negative rate (0.9%) suggests routine short-interval follow-up MRI may be unnecessary following benign concordant MRI-guided biopsy.

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Is 6-Month Radiologic Imaging Necessary after Benign Breast Biopsy? Review of Literature and Multicenter Experience

The American Surgeon ◽

10.1177/000313481508101221 ◽

2015 ◽

Vol 81 (12) ◽

pp. 1224-1227 ◽

Cited By ~ 2

Author(s):

Alina M. Mateo ◽

Arthur M. Frankel

Keyword(s):

Health Care ◽

Retrospective Study ◽

Breast Biopsy ◽

Short Interval ◽

Review Of Literature ◽

Ultrasound Guided ◽

Short Term ◽

Radiologic Imaging

A retrospective study of 786 patients was conducted to determine the necessity of a 6-month interval study after a benign stereotactic or ultrasound-guided breast biopsy. These results were compared with those of other centers. After reviewing the data, we found few patients developed cancer after their original biopsy, and for those that did, the 6-month study did not contribute to an earlier diagnosis. Those short-term interval radiologic studies that were interpreted as concerning were all benign when biopsied. A 6-month study contributes to higher costs of health care and can be inconvenient, painful, and anxiety producing to patients. Short-interval follow-up was found to be unnecessary.

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Estrogen Alone in Postmenopausal Women and Breast Cancer Detection by Means of Mammography and Breast Biopsy

Journal of Clinical Oncology ◽

10.1200/jco.2009.24.8799 ◽

2010 ◽

Vol 28 (16) ◽

pp. 2690-2697 ◽

Cited By ~ 23

Author(s):

Rowan T. Chlebowski ◽

Garnet Anderson ◽

JoAnn E. Manson ◽

Mary Pettinger ◽

Shagufta Yasmeen ◽

...

Keyword(s):

Breast Cancer ◽

Postmenopausal Women ◽

Cancer Detection ◽

Breast Biopsy ◽

Short Interval ◽

Screening Mammography ◽

Breast Cancer Detection ◽

Early Years ◽

Breast Cancers

Purpose As the influence of estrogen alone on breast cancer detection is not established, we examined this issue in the Women's Health Initiative trial, which randomly assigned 10,739 postmenopausal women with prior hysterectomy to conjugated equine estrogen (CEE; 0.625 mg/d) or placebo. Methods Screening mammography and breast exams were performed at baseline and annually. Breast biopsies were based on clinical findings. Effects of CEE alone on breast cancer detection were determined by using receiver operating characteristic (ROC) analyses of mammogram performance. Results After a 7.1-year mean follow-up, fewer invasive breast cancers were diagnosed in the CEE than in the placebo group, but the difference was not statistically significant. Use of CEE alone increased mammograms with short-interval follow-up recommendations (cumulative, 39.2% v 29.6.3%; P < .001) but not abnormal mammograms (ie, those suggestive of or highly suggestive of malignancy; cumulative, 7.3% v 7.0%; P = .41). Breast biopsies were more frequent in the CEE group (cumulative, 12.5% v 10.7%; P = .004) and less commonly diagnosed as cancer (8.9% v 15.8%, respectively, with positive biopsies; P = .04). Mammographic breast cancer detection in the CEE group was significantly compromised only in the early years of use. Conclusion CEE alone use for 5 years results in approximately one in 11 and one in 50 women having otherwise avoidable mammograms with short-interval follow-up recommendations or breast biopsies, respectively. Although the breast biopsies on CEE were less commonly diagnosed as cancer, breast cancer detection was not substantially compromised. These findings differ from estrogen-plus-progestin use, for which significantly increased abnormal mammograms and a compromise in breast cancer detection are seen.

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Breast Cancer Detection with Short-Interval Follow-up Compared with Return to Annual Screening in Patients with Benign Stereotactic or US-guided Breast Biopsy Results

Radiology ◽

10.1148/radiol.14140036 ◽

2015 ◽

Vol 275 (1) ◽

pp. 54-60 ◽

Cited By ~ 9

Author(s):

Jason M. Johnson ◽

Alisa K. Johnson ◽

Ellen S. O’Meara ◽

Diana L. Miglioretti ◽

Berta M. Geller ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Detection ◽

Breast Biopsy ◽

Short Interval ◽

Breast Cancer Detection ◽

Annual Screening

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Short interval follow-up after a benign concordant MR-guided vacuum assisted breast biopsy – is it worthwhile?

European Radiology ◽

10.1007/s00330-014-3125-x ◽

2014 ◽

Vol 24 (6) ◽

pp. 1176-1185 ◽

Cited By ~ 19

Author(s):

Sara D. Shaylor ◽

Samantha L. Heller ◽

Amy N. Melsaether ◽

Dipti Gupta ◽

Avani Gupta ◽

...

Keyword(s):

Breast Biopsy ◽

Short Interval

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Advantages and Challenges of Using Breast Biopsy Markers

Journal of Breast Imaging ◽

10.1093/jbi/wbab052 ◽

2021 ◽

Author(s):

Taghreed I Alshafeiy ◽

Alison Matich ◽

Carrie M Rochman ◽

Jennifer A Harvey

Keyword(s):

Breast Biopsy ◽

Percutaneous Biopsy ◽

Standard Of Care ◽

Benign Lesions ◽

Accurate Identification ◽

Biopsy Tissue ◽

Local Practices ◽

Frequency Of Use ◽

Lesion Localization

Abstract Percutaneous image-guided biopsy procedures are the standard of care for histologic assessment of suspicious breast lesions. Post-biopsy tissue markers (clips) optimize patient management by allowing for assessment on follow-up imaging and precise lesion localization. Markers are used to ensure accurate correlation between imaging modalities, guide preoperative localization for malignant and high-risk lesions, and facilitate accurate identification of benign lesions at follow-up. Local practices differ widely, and there are no data detailing the exact frequency of use of clips for different breast biopsies. There are many indications for biopsy marker deployment, and some difficulties may be encountered after placement. The placement of biopsy markers has many advantages and few disadvantages, such that deployment should be routinely used after percutaneous biopsy procedures with rare exception.

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4–20 Breast Cancer Yield for Screening Mammographic Examinations With Recommendation for Short-Interval Follow-up

Breast Diseases A Year Book Quarterly ◽

10.1016/s1043-321x(05)80279-6 ◽

2006 ◽

Vol 16 (4) ◽

pp. 351-352

Author(s):

R.J. Brenner

Keyword(s):

Breast Cancer ◽

Short Interval

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Radiologic and Pathologic Correlation for Lactating Adenomas

Journal of Breast Imaging ◽

10.1093/jbi/wbaa108 ◽

2021 ◽

Vol 3 (2) ◽

pp. 208-214

Author(s):

Hoiwan Cheung ◽

Elizabeth U Parker ◽

Mark R Kilgore ◽

John R Scheel

Keyword(s):

Breast Imaging ◽

Short Interval ◽

Malignant Potential ◽

Postpartum Women ◽

Breast Lesions ◽

Lactating Women ◽

Neoplastic Processes ◽

Imaging Characteristics ◽

Benign Breast Lesions

Abstract Lactating adenomas are benign breast lesions that occur in pregnant, lactating, and postpartum women. These lesions have no associated malignant potential; their origin is disputed with no consensus on whether they represent hyperplastic or neoplastic processes. On ultrasound, lactating adenomas are classically described as solid, circumscribed, parallel masses with iso/hypoechoic internal echotexture and posterior enhancement. Histologically, lactating adenomas appear as circumscribed nodules of tightly packed lobular acini with extensive lactational change during pregnancy or the postpartum period. Masses in pregnant and lactating women with probably benign imaging characteristics—oval, circumscribed, parallel, iso/hypoechoic—can be managed with short interval follow-up (BI-RADS 3) rather than biopsy. However, lactating adenomas can also demonstrate characteristics that overlap with pregnancy-associated breast cancer, such as margins that are not circumscribed, prompting biopsy to exclude pregnancy-associated carcinoma. Breast imaging radiologists must be aware of the variable appearances of lactating adenomas to appropriately manage pregnant and lactating women presenting with palpable lumps.

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