Lauren Brett Raher MD, Abstract Co-Author: Nothing to Disclose

Dorota J. Wisner MD, PhD, Presenter: Nothing to Disclose

Belinda Chang MD, Abstract Co-Author: Nothing to Disclose

Laura J. Esserman MD, Abstract Co-Author: Nothing to Disclose

Nola Michiko Hylton PhD, Abstract Co-Author: Research grant, Hologic, Inc

Bonnie N. Joe MD, PhD, Abstract Co-Author: Investigator, Sentinelle Medical, Inc

Purpose: To determine outcomes on follow-up MRI after benign MRI-guided breast biopsy.

Methods: We retrospectively identified 234 patients who underwent MRI guided breast procedures over a 5 year period from 11/05-6/10. A subset of 172 lesions in 150 patients demonstrated concordant benign pathology. Cases with atypia, malignancy, discordant pathology, and subsequent surgical excision were excluded. In addition, patients with breast cancer in the same quadrant as the benign biopsy were excluded. Follow-up imaging after benign MRI guided biopsy was tracked, and compliance with the 6-month post-biopsy MRI recommendation was recorded. A group of 69 patients who underwent at least one 6 month follow-up MRI was evaluated for the emergence of false negative biopsies. False negatives were discovered by identifying lesions that underwent repeat location-specific biopsy due to a suspicious appearance on follow-up MRI.

Results: Compliance with the recommended 6 month follow-up MRI after a benign, concordant MRI guided biopsy was as follows: of 150 patients given this recommendation, 42 obtained a follow-up MRI at 6 months, 28 patients at or beyond one year, and 75 has no MRI follow-up. Out of the 69 patients who had diagnostic-quality follow-up imaging, three patients underwent repeat biopsy that yielded malignancy, confirming a group of false negatives. All three cases demonstrated a suspicious appearance on follow-up MRI performed at 6 months.

Conclusions: Imaging surveillance recommendations following benign MRI guided breast biopsy are not universally established. To identify false negatives, our institution routinely recommends a 6 month follow-up MRI after a concordant benign MRI guided breast biopsy. Given the limitations of MRI for immediate confirmation of accurate lesion sampling, short interval follow-up imaging is needed to identify cases with undersampling. In our review, we found false negatives in 4.5% of patients who had a follow-up MRI.

Clinical Relevance: Short interval follow-up imaging is important after benign, concordant MRI-guided breast biopsies to identify false negatives and avoid delaying the diagnosis of breast cancer.

Raher, L, Wisner, D, Chang, B, Esserman, L, Hylton, N, Joe, B, False Negatives Found on Follow-up MRI after Benign Concordant MRI-guided Breast Biopsies.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11007356.html