Study Finds ‘Overmanagement’ Of Benign Breast Disease
Contrary to current guidelines, women with benign breast biopsies do not need follow-up at six months; they may not need close surveillance at all, a new study shows.
The study, conducted at Moffitt Cancer Center in Tampa, FL, followed 388 patients for six, 12 and 24 months. No cancer was found in these patients at six and 12 months, said Shannon Reed, MD, one of the authors of the study. “Of the 197 follow-up examinations performed at 24 months, two women were positive for cancer in a different area than had been previously biopsied,” said Dr. Reed. An annual mammogram, as part of regular preventive care, could replace the need for benign breast disease follow-up of these patients, said Dr. Reed
“The National Comprehensive Cancer Network guidelines recommend that patients with benign breast biopsies undergo follow-up (which can include imaging and a physical exam) every six to 12 months for one to two years,” said Dr. Reed. However, “the low incidence of breast cancer occurring over two years may obviate close surveillance, thereby reducing radiation exposure to the patients, and reducing health care dollars,” said Dr. Reed.
The close surveillance over the two year time period, led to more than 6% of these women having an additional biopsy performed, all of which were benign. This indicates “over-treatment” of these patients as well as “overmanagement,” Dr. Reed said.
“The study results are changing the way we practice,” said Dr. Reed. “We are recommending diagnostic imaging follow-up annually for two years, followed by a return to routine screening,” she said.
The study will be presented May 3, 2012 at the American Roentgen Ray Society Annual Meeting in Vancouver, Canada.
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