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Manjoros DT , Collett AE, Alberty-Oller JJ, Frazier TG, Barrio AV

The Value of Six Month Interval Imaging Following Benign Radiologic-Pathologic Concordant Minimally Invasive Breast Biopsy. Manjoros DT , Collett AE, Alberty-Oller JJ, Frazier TG, Barrio AV. Comprehensive Breast Center, Bryn Mawr Hospital. Interval imaging. INTRODUCTION.

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Manjoros DT , Collett AE, Alberty-Oller JJ, Frazier TG, Barrio AV

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  1. The Value of Six Month Interval Imaging Following Benign Radiologic-Pathologic Concordant Minimally Invasive Breast Biopsy Manjoros DT, Collett AE, Alberty-Oller JJ, Frazier TG, Barrio AV Comprehensive Breast Center, Bryn Mawr Hospital

  2. Interval imaging INTRODUCTION • Percutaneous breast biopsy represents “best practice”¹ • Correlation of histologic and imaging findings strongly endorsed¹ • NCCN guidelines recommend follow-up imaging 6-12 month after benign concordant breast biopsy for a period of 1-2 years • Incidence of discordance low² and value of short-term interval imaging questionable ¹Silverstein MJ, JACS, 2009 ²Liberman L, Cancer, 2000

  3. Interval imaging METHODS • 689 patients identified that underwent image-guided breast biopsy at Bryn Mawr Hospital in 2010 • Biopsy type included stereotactic, ultrasound-guided or MRI-guided biopsy • All image-guided biopsies performed by radiologists who met criteria set forth by American College of Radiology Breast Center of Excellence • All charts were evaluated for documentation of concordance assessment

  4. Interval imaging: Results CONCORDANCE ASSESSMENT BenignPatients N = 498 Surgical excision 44/498 (8.8%) Noexcision454/498 (91.2%) No radiologyaddendum 114/454(25.1%) Radiology addendum32/44 (72.7%) No radiology addendum 12/44 (27.3%) Radiologyaddendum 340/454(74.9%) Discordant8/32 (25%) Concordant337/340 (99.1%) Concordant 24/32 (75%) Discordant 3/340 (0.9%)

  5. Interval imaging: Results OUTCOMES IN 11 DISCORDANT LESIONS • In total, 11/372 (3.0%) discordant minimally invasive biopsies

  6. Interval imaging: Results CANCER INCIDENCE WITH INTERVAL IMAGING • 169 (50.1%) of 337 benign concordant patients underwent interval imaging < 12 months • 5(3%) with suspicious imaging • 3 at biopsy site, 2 away from biopsy site • 1 cancer was identified, representing 0.6% (95% CI, 0 – 3.6%) of all benign concordant patients • No cancers were identified with interval imaging after stereotactic or ultrasound-guided biopsy

  7. Interval imaging: Results COST ANALYSIS

  8. Interval imaging CONCLUSION • Documentation of imaging-histologic correlation essential • Concordance assessment as a quality measure • Our data do not support the routine use of interval imaging following benign concordant breast biopsy • No interval imaging with specimen radiography • Selective use should be considered when confirmation of lesion retrieval difficult

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