Does post-biopsy mammography at short-term interval contribute to early detection of cancer in patients diagnosed with benign-concordant microcalcifications on stereotactic biopsy?

Background: Currently, there are no strict post-biopsy guidelines for managing stereotactic biopsy-proven benign lesions manifesting as microcalcifications on mammography without an accompanying mass. Objectives: To evaluate whether short-term follow-up mammography contributes to the detection of early cancer for patients with microcalcification-only lesions that were diagnosed as benign stereotactic biopsy. Patients and Methods: Two-hundred sixty-two microcalcification-only lesions in 259 women (mean age: 47.7 years) who were diagnosed as benign on stereotactic biopsy and been followed with mammography for at least 2 years were included. Serial mammograms were reviewed from the initial pre-biopsy mammograms to the most recent examination. Mammographic findings were designated as stable, decreased, or newly developed microcalcifications. Medical records of each patient were reviewed for clinical information and pathology results of additional biopsy or surgical procedures. Results: Of the 262 microcalcifications diagnosed as benign on stereotactic biopsy, 258 (98.5%) were finally diagnosed as benign, one (0.4%) as high-risk lesion, and three (1.1%) as malignant. The three cancers were all diagnosed as ductal carcinoma in situ (DCIS) at 31, 36 and 6 months after initial biopsy. The DCIS diagnosed at 6 months post-biopsy had no mammographic changes, and was detected on breast ultrasonography, while the remaining two cases had no detectable findings on the short-term follow-up mammography. Conclusion: Short-term follow-up mammography did not contribute in detecting additional breast cancers, and may have a limited role in patients diagnosed with benign-concordant microcalcifications on large-bore stereotactic biopsy.