title: Why are patients noncompliant with follow-up recommendations after MRI-guided core needle biopsy of suspicious breast lesions?
abstract: OBJECTIVE
  The objective of this study was to investigate patient and breast MRI characteristics associated with noncompliance with recommended follow-up after MRI-guided core needle biopsy of suspicious breast lesions.
  
  
  METHODS
  A retrospective review was performed of 576 breast lesions biopsied under MRI guidance between 2007 and 2010. Patient follow-up was obtained from the medical record and from contact with referring physicians.
  
  
  RESULTS
  Of 415 women who underwent 576 MRI-guided core needle biopsies for suspicious breast lesions, 123 (29.6%) patients representing 154 of 576 (26.7%) lesions were noncompliant with recommended excision or 6-month MRI follow-up. Referring physicians provided information for 63% (97/154) of lesions in noncompliant patients, of which 49.5% (48/97) were followed by mammography instead of excision or MRI. Noncompliance with MRI follow-up was significantly associated with referral for biopsy by outside hospital physicians (odds ratio [OR], 2.40; p = 0.0001) and with referral for screening MRI (1.46; p = 0.093) and biopsy of a focus or foci lesion (1.63; p = 0.088). Among 178 lesions in patients compliant with follow-up MRI after MRI-guided core needle biopsy, 7.9% (14/178) had abnormal follow-up MRI results, half of which (3.9%, 7/178) were found on repeat biopsy to be high-risk or malignant.
  
  
  CONCLUSIONS
  Institutions performing MRI-guided core biopsies should be aware that patients referred from outside institutions are more likely to be noncompliant with recommended follow-up. Strategies to improve follow-up should include educating patients on the difference between mammography and MRI follow-up.
authors.affiliation: 1 Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305.
authors.forename: Matthew O
authors.initials: MO
authors.lastname: Thompson
authors.forename: Jafi
authors.initials: J
authors.lastname: Lipson
authors.forename: Bruce
authors.initials: B
authors.lastname: Daniel
authors.forename: Chivonne
authors.initials: C
authors.lastname: Harrigal
authors.forename: Paul
authors.initials: P
authors.lastname: Mullarkey
authors.forename: Sunita
authors.initials: S
authors.lastname: Pal
authors.forename: Atalie C
authors.initials: AC
authors.lastname: Thompson
authors.forename: Debra
authors.initials: D
authors.lastname: Ikeda
mesh_terms: D062005:Biopsy, Large-Core Needle; D001943:Breast Neoplasms / Q000473:pathology* / Q000523:psychology*; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D053783:Magnetic Resonance Imaging, Interventional; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies