pHoag Family Cancer Institute, Newport Beach, California and University of Southern California, Los Angeles, California; Commission on Nuclear Medicine and Molecular Imaging. qSpecialty Chair, NYU Clinical Cancer Center, New York, New York. Reprint requests to: publications@acr.org Imaging after Breast Surgery proliferative lesions with atypia [7]. Almost 30% of women with breast cancer have a history of benign breast disease [4]. Although there are no relevant studies examining mammographic follow-up intervals of benign breast disease following surgical biopsy, there are some studies examining imaging intervals following benign core biopsy. In populations with nonproliferative lesions or proliferative lesions without atypia, imaging intervals of 6 months compared to routine annual screening did not improve cancer detection rates or change invasive cancer rates, stage, tumor size, or nodal status [11,12]. The studies on proliferative lesions with atypia, examining the need for excision and, if not excised, need for short interval follow-up, are varied [13-16] and are outside the scope of this document. Atypical ductal hyperplasia on core biopsy typically warrants surgical consultation and/or multidisciplinary discussion regarding the benefits and risks of subsequent excision. There is more varied practice in management of atypical lobular hyperplasia, LCIS, and flat epithelial atypia found on core biopsy. One study of more than 2 million screening mammograms in nearly 800,000 women, with 15% having a self- reported history of prior benign percutaneous or excisional breast biopsy, showed no difference in mammographic sensitivity; however, there was decreased specificity and mammographic performance, which was attributed to tissue characteristics rather than the biopsy itself [18].
Imaging after Breast Surgery. pHoag Family Cancer Institute, Newport Beach, California and University of Southern California, Los Angeles, California; Commission on Nuclear Medicine and Molecular Imaging. qSpecialty Chair, NYU Clinical Cancer Center, New York, New York. Reprint requests to: publications@acr.org Imaging after Breast Surgery proliferative lesions with atypia [7]. Almost 30% of women with breast cancer have a history of benign breast disease [4]. Although there are no relevant studies examining mammographic follow-up intervals of benign breast disease following surgical biopsy, there are some studies examining imaging intervals following benign core biopsy. In populations with nonproliferative lesions or proliferative lesions without atypia, imaging intervals of 6 months compared to routine annual screening did not improve cancer detection rates or change invasive cancer rates, stage, tumor size, or nodal status [11,12]. The studies on proliferative lesions with atypia, examining the need for excision and, if not excised, need for short interval follow-up, are varied [13-16] and are outside the scope of this document. Atypical ductal hyperplasia on core biopsy typically warrants surgical consultation and/or multidisciplinary discussion regarding the benefits and risks of subsequent excision. There is more varied practice in management of atypical lobular hyperplasia, LCIS, and flat epithelial atypia found on core biopsy. One study of more than 2 million screening mammograms in nearly 800,000 women, with 15% having a self- reported history of prior benign percutaneous or excisional breast biopsy, showed no difference in mammographic sensitivity; however, there was decreased specificity and mammographic performance, which was attributed to tissue characteristics rather than the biopsy itself [18].