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Follow-up of Breast Lesions Diagnosed as Benign with Stereotactic Core-Needle Biopsy: Frequency of Mammographic Change and False-Negative Rate¹

¹ From the Department of Diagnostic Radiology, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06520. From the 1997 RSNA scientific assembly. Received August 11, 1998; revision requested September 25; revision received November 10; accepted January 11, 1999. Address reprint requests to C.H.L.

PURPOSE: To determine how often lesions diagnosed as benign with stereotactic core-needle biopsy (SCNB) change at follow-up mammography and to determine the optimal follow-up strategy and the delayed false-negative rate.

MATERIALS AND METHODS: From July 1992 through December 1995, 355 of 540 cases (66%) in which SCNB yielded benign results were managed with follow-up mammography. Mammographic follow-up was available for 298 of these cases (84%). Follow-up mammography reports were reviewed. When a change was reported, pre- and postbiopsy mammograms, pathology reports, and results of subsequent mammographic follow-up were reviewed.

RESULTS: Mammographic change occurred in 21 of 298 cases (7%) at intervals of 6–55 months (mean, 20 months). Change occurred after initial mammographic stability in 10 of 21 cases. Repeat biopsy was performed in 18 of 21 cases. Malignancy was diagnosed in two cases: one mass that changed at 6 months and one case of microcalcifications that changed at 24 months. This represented a delayed false-negative rate of 2% (two of 105 malignancies among 540 biopsies).

CONCLUSION: A small percentage of cases diagnosed as benign with SCNB will change on follow-up mammograms, which may necessitate repeat biopsy. These results suggest that 6-month follow-up for cases that yield nonspecific benign results at SCNB and yearly screening mammography for cases with specific benign results is a reasonable management strategy.

Index terms: Breast, biopsy, 00.1267 • Breast neoplasms, diagnosis, 00.1267 • Breast radiography, utilization

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