Sara Daniel Shaylor MD, Presenter: Nothing to Disclose

Avani Patel Gupta MD, Abstract Co-Author: Nothing to Disclose

Cecilia Luz Mercado MD, Abstract Co-Author: Nothing to Disclose

Amy Noel Melsaether MD, Abstract Co-Author: Nothing to Disclose

Samantha Lynn Heller MD, PhD, Abstract Co-Author: Nothing to Disclose

Heather Illana Greenwood MD, Abstract Co-Author: Nothing to Disclose

Linda Moy MD, Abstract Co-Author: Nothing to Disclose

To determine whether a short-interval follow-up (SIFU) is necessary after a benign concordant MRI-guided vacuum assisted breast biopsy.

Institutional review board approved, HIPAA compliant retrospective review of consecutive MRI-guided biopsies performed at our institution over a 3 year period (2007-2010) yielded a total of 376 lesions in 336 women, including 233 with benign concordant results as determined by the performing radiologist. 6 month follow-up of all benign biopsies was recommended. Patients who went to mastectomy or ipsilateral lumpectomy were excluded, yielding a total of 193 biopsies. Indication for the original study, biopsy results, and follow-up compliance were reviewed. Outcomes of subsequent MRI and mammography were included where available. In non-compliant patients, pathology database search and linkage with the state tumor registry were performed to assess for ipsilateral breast malignancy.

Indications for breast MRI were high-risk screening (68%), extent of disease (23%), and problem solving (9%). Overall follow-up rate after benign breast biopsy with MRI was 41% (79/193) and with mammography was 46% (88/193). Thirty-two (17%) women without radiologic follow-up were referred from outside facilities for their biopsy. Of the 79 patients who did follow-up with MRI, 42% presented within 6 months, 41% between 7 and 11 months and 18% after 1 year, with a mean follow-up time of 9.6 months. At follow-up, 97% of lesions were stable or decreased. Two lesions (3%) increased in size and were recommended for surgical excision. One lesion was stable at 12 months, increased at 24 months, and yielded DCIS at excision. The second lesion, excised at 6 month follow-up, was benign.

The cancer yield in our benign concordant breast MRI biopsy population was 1.3% (1/79) with no cancers detected at 6 month follow-up. Our data suggests that follow-up at twelve months is reasonable. It is likely that annual follow-up will improve compliance given insurance restrictions and limited facility availability, although this warrants additional study.

Twelve-month follow-up after benign concordant breast MRI biopsy may be reasonable since no cancers were detected at 6 months and the overall cancer yield was 1.3% in our high risk population.

Shaylor, S, Gupta, A, Mercado, C, Melsaether, A, Heller, S, Greenwood, H, Moy, L, Short Interval Follow-up after a Benign Concordant MR-guided Vacuum-assisted Breast Biopsy: Is It Worthwhile?.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11008249.html