NEW YORK (Reuters Health) – For a palpable breast mass with benign features on ultrasound, short-term follow-up is a reasonable alternative to immediate biopsy, particularly in a young woman with probable fibroadenoma, researchers report in the December issue of the American Journal of Roentgenology.

“Many palpable lumps that are solid (not a fluid filled cyst) on ultrasound undergo either needle or surgical biopsy, even when they appear benign on imaging,” Dr. Jennifer A. Harvey, who led the study, noted in an email to Reuters Health.

To investigate the feasibility of short-term follow up of lumps believed to be fibroadenoma, she and colleagues at the University of Virginia, Charlottesville, evaluated 375 palpable lesions detected in 320 women over a six and half year period.

“We followed up on the outcome of these women for an average of 2.7 years, and found that among these lesions only one was a cancer that was only two millimeters in size,” Dr. Harvey said.

This is an “acceptably low prevalence” of breast cancer (0.3%) — “so low that short-term follow-up is a reasonable alternative to biopsy” in these women, Dr. Harvey added in a statement accompanying the study.

The findings of this study, Dr. Harvey concludes, “support close follow up by repeating imaging in six months as an alternative to immediate biopsy. Of course, the mass must have a benign appearance on imaging and biopsy should be considered if the clinical exam is concerning or if the lump increases in size,” she emphasized.

Such a strategy, she added, “may reduce the number of biopsies that result in benign findings. There is also significant cost savings associated with using short-term follow-up rather than immediate biopsy.”

Reference:
Am J Roentgenol 2009;193:1723-1730.