Patients with high-risk breast lesions benefit from surgical consultations

Breast biopsies with benign results, or false-positive mammograms, are often listed as a potential harm of breast cancer screening. But some benign biopsies still reveal high-risk lesions, meaning the patients are at an increased risk of developing breast cancer. Subsequent screening adherence is important for those patients, according to new study published in Radiology, and there is additional value in those patients undergoing a surgical consultation.

Looking to learn how the diagnosis of a high-risk lesion impacted a patient’s overall adherence to mammographic screening, the authors studied more than 200 patients who underwent stereotactic biopsy that revealed a high-risk lesion between January 2012 and December 2014. More than 66 percent of those patients underwent surgery, and screening adherence among the surgical group was more than 74 percent for biennial mammography and 70 percent for annual mammography. Among patients in the nonsurgical group, screening adherence was significantly worse, coming in at 40 percent for biennial mammography and 32 percent for annual mammography.

“Patients who did not undergo surgery were significantly less likely to return to screening than those who underwent surgery, both at one year and at two years, which is consistent with prior findings that patients who undergo benign breast surgery harbor an increased level of self-perceived cancer risk, motivating return to screening,” wrote Yiming Gao, MD, department of radiology at the NYU Langone Medical Center in New York City, and colleagues.

In addition, patients in the nonsurgical group who followed screening recommendations were “significantly more likely” to have had a surgical consultation than patients who did not follow screening recommendations.

“Specialist care by a breast surgeon was of benefit in our study, improving screening adherence and risk reduction,” the authors wrote. “Radiologists as imaging specialists can similarly play a positive role, especially in helping patients navigate rapidly changing and often conflicting screening guidelines, to optimize individualized care.”

Gao et al. noted that their study did have several limitations. Adherence could only be assessed up to two years, for instance, and “socioeconomic status and access to insurance coverage in the subjects were not specifically evaluated.”