Cathleen Clare Heffernan MD, Abstract Co-Author: Nothing to Disclose

Kathryn Iwata, Presenter: Nothing to Disclose

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

The purpose of this project is to determine the utility of short interval follow-up after benign concordant stereotactic core biopsy.

This study is an IRB approved, HIPAA compliant retrospective review of stereotactic core biopsies performed between 2004 and 2011 using a 9 or 11-gauge vacuum assisted biopsy device yielding benign concordant pathology results. Excluded from the study were high-risk lesions, lesions with discordant results and technically unsuccessful biopsies.  Radiologic-pathologic concordance was evaluated by the radiologist who performed the biopsy. Benign concordant cases were evaluated for outcomes at short term and long term follow-up, re-biopsy rates and false negatives.

A total of 1532 stereotactic core biopsies were performed at our institution during a 7-year time period.  Pathology results yielded 842 (55%) benign, 259 (17%) high-risk or atypical and 383 (25%) malignant lesions.  Of the benign cases, 81% (686/842) returned for imaging follow-up: 54% (372/686) returned for short interval follow-up (<8 months), 34% (230/686) returned for annual exam (between 8 and 15 months) and 12% (84/686) returned after 15 months.  The mean age was 54 years, mean length of subsequent follow-up time was 33 months after biopsy and mean number of samples taken was nine.  Five cases were re-biopsied (< 1%) within the next year.  Of those re-biopsied, none were malignant.  Four cases revealed benign pathology while one revealed flat epithelial atypia and radial scar requiring excision.

No false negatives were identified on short-interval and long term follow-up after 9 gauge and 11 gauge stereotactic core biopsies at our institution.  Prior studies of benign stereotactic core biopsies have recommended 6 month follow-up imaging to evaluate for false negatives. Our data support the elimination of the short interval follow-up mammogram for benign concordant results.

By reducing the number of follow-up imaging studies needed after benign concordant biopsies, we can reduce health care costs as well as reduce emotional stress from extra unnecessary tests for our patients.

Heffernan, C, Iwata, K, Mercado, C, Clinical Utility of Short-term Follow-up After Benign Concordant Stereotactic Breast Biopsy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002269.html