Original ResearchValue of a short-term imaging follow-up after a benign result in a one-stop breast unit: Is it still useful?

- Follow-up cancer detection rate is poor after a benign biopsy or fine needle aspiration.
- Most of cancers detected were at early stage.
- The average cost was 140€ per patient.
- The cost to diagnose one cancer was 19,043€.
- This cost appeared too high regarding the benefit.

IntroductionA short-term radiologic follow-up after a benign breast biopsy or fine needle aspiration (FNA) is recommended in many guidelines. However, the current trend is to reduce imaging investigations, radiation dose and costs. The objectives of this study were to evaluate the cancer detection rate at short-term follow-up and to estimate its cost.MethodsWe retrospectively assessed all consecutive patients referred to our 'one-stop' breast unit between 2004 and 2012, with a benign histological or cytological result and at least one short-term follow-up within 3-12 months after the initial diagnosis. We evaluated the number of cancers detected, as well as the mean cost to detect each cancer and per patient.ResultsAbout 1366 patients were eligible for this study. Ten patients were diagnosed with cancers (0.73%) at short-term follow-up; six of 10 were low-grade tumours or ductal carcinoma in situ. The cost for detecting one cancer was 19,043€, with mean cost per patient of 139€.ConclusionThe cancer detection rate at short-term follow-up after benign biopsy or FNA was low and was similar to that of most national screening programs. The cost of cancer detection appeared high, considering that most cancers were indolent. This suggests that radiologic follow-up could reasonably be carried out at a later point in time.