RSNA 2019 MRI Preview

Why do so few women follow up on MRI-guided biopsies?

By Wayne Forrest, staff writer

November 6, 2019 --

Friday, December 6 | 10:40 a.m.-10:50 a.m. | SST01-02 | Room E450A
Very few women heed the recommendation to follow up a benign MRI-guided breast biopsy with an MRI scan six or 12 months later. The question is: What's stopping them?

To investigate this, researchers retrospectively reviewed 139 benign concordant MRI biopsies in 127 patients from January 2013 to January 2018. They excluded biopsy results with high-risk lesions or malignancies. Each benign concordant MRI biopsy case included the patient's age, pathology, any repeat biopsies, and any subsequent malignancies. The patient file also included any recommendations for a six- or 12-month follow-up MRI scan and communication with the referring physician.

The researchers found that a six-month follow-up MRI scan was recommended for 63 patients (50%), but only 33 of them (26%) actually obtained the exam.

Why is the rate of return so poor for follow-up breast MRI scans? One reason is a lack of communication, according to study presenter Dr. Shruthi Ram, an assistant professor of diagnostic imaging at Brown Alpert Medical School. Communication between patient and physician for the six-month follow-up recommendation was documented in only six cases (9%).

On the other hand, most patients without a follow-up MRI did undergo a follow-up mammogram an average of one year after the MRI biopsy, and results proved benign. There was no need for a repeat biopsy and no sign of subsequent malignancies.

Ram and colleagues suggested that a careful assessment of each benign concordant MRI biopsy might be more appropriate than a routine six-month follow-up MRI recommendation.