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. 2021 Oct:59:135-143.
doi: 10.1016/j.breast.2021.06.008. Epub 2021 Jun 26.

Ten years follow-up of histologically benign calcifications in the breast after vacuum-assisted stereotactic biopsy (VASB): Is additional mammographic follow-up warranted?

Sara van Bekkum  1 , Francina E M Dams  2 , Pieter J Westenend  3 , Joost van Rosmalen  4 , Marian B E Menke-Pluijmers  1 , Marc C J M Kock  5
Affiliations

Ten years follow-up of histologically benign calcifications in the breast after vacuum-assisted stereotactic biopsy (VASB): Is additional mammographic follow-up warranted?

Sara van Bekkum et al. Breast. 2021 Oct.

Abstract

Objective: This study assessed the short-term and the long-term breast cancer rate in patients with benign histopathologic results after a vacuum-assisted stereotactic biopsy (VASB) for calcifications.

Methods: In a retrospective cohort study, all consecutive patients who had a benign diagnosis after VASB to analyze breast calcifications. Data of breast cancer development at short-term (four years) and long-term follow-up was gathered. Breast cancer rates in our cohort were compared to the breast cancer incidence in the general population.

Results: Of 1376 patients who underwent VASB to analyze breast calcifications, 823 had a benign histopathologic diagnosis. During short-term follow-up, eight patients developed breast cancer. During the mean long-term follow-up period of 9.3 ± 3.1 years, 22 patients were diagnosed with ipsilateral breast cancer. The incidence rate of breast cancer after benign biopsy was comparable to the rate in the general population.

Conclusion: In patients with VASB-confirmed benign calcifications of the breast, we found no excess incidence of ipsilateral breast cancer during ten years follow-up. Therefore, in patients with an increased risk of breast cancer (due to a history of breast cancer or familial risk) annual mammography should be sufficient. Patients with a population-based risk may be monitored via biennial mammography by the national screening program. More frequent screening would provide no benefit.

Keywords: Benign pathology; Breast; Clustered calcifications; Follow-up; Vacuum-assisted stereotactic biopsy.

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Conflict of interest statement

Declaration competing interest None.

Figures

Fig. 1
Fig. 1
Patient selection and management flowchart for patients with clustered calcifications. VASB = Vacuum-Assisted Stereotactic biopsy; High risk lesion = The histopathologic result included flat epithelial atypia, atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, papillary lesions, radial scar or phyllodes tumor; Radiologic-pathologic. discordant lesion = the pathologic result provided not an acceptable explanation for the imaging feature.
Fig. 2
Fig. 2
Cumulative incidence of the development of ipsilateral breast cancer with 95% confidence intervals compared to the general background risk in ten years subsequent to biopsy.
See this image and copyright information in PMC

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