According to the guidelines set by the National Comprehensive Cancer Network (NCCN), a benign biopsy should be followed up by routine imaging within 6 to 12 months.
Such practice has been followed since it was set by the NCCN by oncologists, but a recent study has shown that maybe this guideline is subjecting patients to unnecessary financial and medical stress that won’t be beneficial to their health in general or to early detection of breast cancer.
During the American Society of Breast Surgeons Annual Meeting in Chicago, on May 2, 2013, Dr. Andrea Barrio, an attending breast surgeon at Bryn Mawr Hospital, in Pennsylvania, announced the results of her recent study, that it would be more beneficial for women who had benign biopsies for breast cancer to wait at least 12 months before they had their routine mammograms.
Dr. Barrio’s study included 337 women who had undergone biopsies for breast cancer with benign results.
169 women had their repeated mammograms in less than 12 months and only one breast cancer was detected, such discovery after such a short interval cost $193,000. 67 women had their mammograms after 12 months or later and no cancer was detected.
101 women had no repeated imagining.
The study concluded that patients who had benign biopsies are stressed both financially and physically when they undergo short interval mammograms, and that the short interval doesn’t really make a difference in the detection of the cancer.
So Dr. Barrio advised during the meeting that the NCCN guideline regarding the interval of the benign biopsy follow-up mammogram should be adjusted to a period of at least 12 months instead of the current interval of 6 to 12 months.
Dr. Barrio also stated that there was less likelihood that a follow-up imaging would find breast cancer at the biopsy site of a benign needle breast biopsy so shortly after the procedure had been done on the patient.
So she recommended that the doctor would wait at least 12 months before doing the follow-up mammogram because that would ensure that the results would be more accurate.
She added, however, that the study didn’t mean to exclude all women from the NCCN guideline, as it would be more advisable for some women to have the short-term interval mammogram based on the ambiguity or vagueness of their initial mammogram prior to the biopsy.
An expert, Dr. Laura Kruper, director of the Cooper Finkel Women's Health Center and co-director of the breast cancer program at the City of Hope Comprehensive Cancer Center in Duarte, California, agreed with the results of Dr. Barrio’s study. However, she commented that this should be done on a selective basis based on the doctor’s opinion, as for some cases it would be necessary for the woman to undergo the mammogram shortly after the benign biopsy due to patient family history or the woman’s own opinion regarding the time she could wait before the next follow-up imaging as some people couldn’t tolerate to wait for a whole year.
Although the study is still considered preliminary and is yet to be validated and published in a peer-review journal, its results make sense in terms of improving patient care and well-being.
