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Imaging within a year of benign breast biopsy has little benefit, study

por Loren Bonner, DOTmed News Online Editor | May 06, 2013
All too often, patients who undergo a benign breast biopsy are later subjected to routine imaging six months after the procedure.

A team of researchers at Bryn Mawr Hospital wanted to investigate how necessary such routine imaging really was. Their new study, presented this week at the American Society of Breast Surgeons Annual Meeting, found that half of the patients with benign lesions received at least one imaging exam during this time period and only one cancer was found.

"Our data do not support the routine use of short-term interval imaging following benign concordance breast biopsy," said lead study author Dr. Demitra Manjoros, a breast fellow at Bryn Mawr Hospital.

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Current National Comprehensive Cancer Network guidelines recommend follow-up imaging at six to 12 months after a benign concordant breast biopsy for a period of one to two years. Concordant means the results on the imaging exam are explained by the findings of the pathology lab. However, the incidence of discordance is low, according to Manjoros, especially with the use of vacuum-assisted biopsy devices. "The value of short-term interval imaging in this setting is questionable," said Manjoros.

For the study, researchers identified 689 patients who underwent image-guided breast biopsy at Bryn Mawr in 2010, specifically stereotactic, ultrasound, and MRI-guided biopsies. Of these, 188 were diagnosed with a malignancy, three had non-breast pathology and 498 had benign findings. Forty-four patients with benign results were also surgically biopsied because of discordant pathology, atypia, papillary lesions or other nonmalignant findings. Interval imaging at less than 12 months after the benign biopsy was obtained for 169 of the concordant patients.

Only one cancer was identified, representing 0.6 percent of all benign concordant patients who had undergone short-term interval imaging. Manjoros notes that this patient had significant complicating factors that would signal to her doctors that she needed follow-up imaging.

To make the point that some of this imaging is causing unnecessary drain on health care dollars, Manjoros said that the amount of money spend to detect one cancer was $192,745 in the patient cohort.

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