Six-Month Short-Interval Imaging Follow-Up for Benign Concordant Core Needle Biopsy of the Breast: Outcomes in 1444 Cases With Long-Term Follow-Up.

Abstract

The purpose of this study is to assess whether 6-month imaging follow-up after benign core needle breast biopsy is important for patient outcomes and whether it depends on nonspecific versus definitive benign biopsy results. Consecutive breast biopsies from 2003 to 2010 were analyzed. Benign concordant lesions with at least 2 years of follow-up were assessed. Pathologic abnormalities were further characterized as having definitive or nonspecific features. A two-tailed Fisher exact test was used to assess the difference in pathologic features among lesions that had progressed. Of 3256 cases, 1705 biopsies in 1602 women were benign concordant and were recommended for 6-month imaging follow-up; the compliance rate was 94.9%. Of these, 1444 biopsies were confirmed as benign with long-term follow-up or excision. At pathologic analysis, 805 (55.7%) benign lesions had definitive features and 639 (44.3%) had nonspecific features. Thirty-four (2.4%) lesions progressed; this was similar for the lesions with definitive (2.6%) and nonspecific (2.0%) features (p = 0.60). The false-negative rate was 0.18%, with a mean of 5.0 cores sampled per lesion. For lesions with benign concordant biopsy results, selection of the follow-up interval should not be dictated by whether the pathologic features are definitive or nonspecific. The number of lesions that progress at imaging follow-up is low. The false-negative rate is low, regardless of modality or lesion type. A low false-negative rate is achievable with a reasonable number of core samples. The 6-month follow-up interval benefits only a small number of patients. Our results suggest that routine imaging after core needle biopsy is safe.