Return to normal: Short-term follow up not necessary after benign breast biopsy

A recent study has found that there is no discernable difference in cancer detection between patients who undergo short-interval follow up (SIFU) or those who return to annual screenings (RTAS) after breast biopsies.

Led by Jason M. Johnson, MD, from the University of California-San Francisco, the report was published online in Radiology.

Percutaneous breast biopsies, a minimally invasive procedure compared to excisional biopsies, are growing in number every year. These biopsies tend to have lower complication rates, cost less and are equal with the more-invasive procedures when it comes to accuracy, according to Johnson and colleagues.

Consensus on follow up care, however, is difficult to come by. Some U.S. medical experts recommend patients who recently had a benign breast biopsy return for a follow up four to six months later. Other experts allow patients to return to routine annual screenings. There are no guidelines for follow-up imaging in these patients, according to Johnson and colleagues.

“The goal of our study was to compare the cancer detection rate and the stage of cancers detected after benign stereotactic or US-guided core breast biopsy between patients with SIFU and those with RTAS,” the authors wrote.

The team used retrospective data from five breast imaging registries, which were made up of 226 radiology facilities. All biopsies used retrospectively in the study were either ultrasound (US) or stereostatic mammography.

The team identified 17,631 benign biopsies identified with SIFU or RTAS. Ipsilateral breast cancers were diagnosed in 27 of 10,715 mammograms in the SIFU group, compared with 16 in the RTAS group.

Of the cancers identified in both groups, 16 were invasive in the SIFU group, compared to 12 in the RTAS group.

The invasive cancer rate per 1,000 among the SIFU and RTAS groups were 1.5 and 1.7, respectively and positive lymph nodes were found in seven patients after SIFU and three after RTAS.

“In our study, the rates of cancer detection between SIFU and RTAS after a benign breast biopsy finding were similar and comparable to the rate of cancers expected in a standard screening population,” Johnson and colleagues wrote.

The research team noted the strength of their research lies in numbers—the sample size studied was large and spanned large, diverse community-based radiology practices in the country.

“Our study suggests that patients may return to annual screening after receiving a concordant benign breast biopsy finding without risk of developing later-stage cancer,” the authors wrote. “This practice may reduce unnecessary healthcare use and cost and minimize mental duress for the patient.”