title: The value of 6-month interval imaging after benign radiologic-pathologic concordant minimally invasive breast biopsy.
abstract: BACKGROUND
  Current National Comprehensive Cancer Network guidelines recommend repeat imaging 6-12 months after a benign radiologic-pathologic concordant image-guided breast biopsy. We hypothesized that interval imaging <12 months after benign concordant biopsy has a low cancer yield and increases health care costs.
  
  
  METHODS
  An institutional review board-approved retrospective chart review identified 689 patients who underwent image-guided breast biopsy at Bryn Mawr Hospital between January and December 2010. Charts were evaluated for documentation of radiologic-pathologic concordance.
  
  
  RESULTS
  Of 689 patients, 188 (27 %) had malignant pathology, 3 (0.4 %) had nonbreast pathology, and 498 (72.3 %) had benign pathology. Of 498 patients with benign findings, 44 (8.8 %) underwent surgical excision as a result of discordance, atypia, papillary lesion, or other benign finding. Of the remaining 454 patients who did not undergo excision, 337 (74.2 %) had documented radiologic-pathologic concordance. Interval imaging <12 months after benign biopsy was obtained in 182 (54.0 %) concordant patients. Five (2.7 %) patients had suspicious [American College of Radiology Breast Imaging-Reporting and Data System (BI-RADS) 4] findings on follow-up imaging. Only one breast cancer was identified, representing 0.5 % (95 % confidence interval 0-3.4) of all benign concordant patients undergoing interval imaging. The cost of detecting a missed cancer with interval imaging after benign concordant biopsy was $41,813.77 in this cohort.
  
  
  CONCLUSIONS
  Interval imaging performed <12 months after benign concordant breast biopsy demonstrated a low yield for the detection of breast cancer and resulted in increased health care costs. Our data support the policy for discontinuation of routine interval imaging after benign concordant biopsy.
authors: Department of Surgery, Comprehensive Breast Center, The Bryn Mawr Hospital, Bryn Mawr, PA, USA.
authors: Demitra T
authors: DT
authors: Manjoros
authors: Abigail E
authors: AE
authors: Collett
authors: Jose J
authors: JJ
authors: Alberty-Oller
authors: Thomas G
authors: TG
authors: Frazier
authors: Andrea V
authors: AV
authors: Barrio
mesh_terms: D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000191:economics / Q000473:pathology* / Q000601:surgery; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography / Q000191:economics*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors