Frequent follow-up for 'probably benign' mammograms questioned.

2003 APR 10 - (NewsRx.com & NewsRx.net) -- Of the nearly 30 million American women who undergo screening mammograms every year, up to 11% receive "probably benign" test results - and therefore are asked to come back for a follow-up mammogram in 3-6 months. But according to a new study by UC Davis researchers, such frequent retesting may be unnecessary.

The study appears in the Journal of the National Cancer Institute.

The UC Davis researchers examined the mammography records of nearly 60,000 women enrolled in the national Women's Health Initiative project, one of the largest preventive health studies in the United States. Among the women who had probably benign mammograms, only 1% went on to develop breast cancer within 2 years, the investigation found.

"This result suggests that the current recommendation - repeat mammography within 6 months - should be reconsidered," said Shagufta Yasmeen, assistant professor of obstetrics and gynecology at UC Davis School of Medicine and Medical Center and lead author of the study. "Going in for a repeat mammogram involves significant psychological trauma, expense and inconvenience, and can lead to unnecessary biopsies and other tests. Our study suggests this recommendation may be given too often, and may not be necessary in some cases. One-year follow-up may be more appropriate for most of these women."

All radiologists in the United States now use the American College of Radiology Breast Imaging Reporting and Data System to classify and report mammography findings. The college divides mammograms into five assessment groups ranging from category 1 (negative) to category 5 (highly suggestive of malignancy), and has specific follow-up recommendations for each group. For category 3 (probably benign) findings, the recommendation is for follow-up testing every 3-6 months until the radiologist determines such frequent follow-up is no longer necessary - usually because the abnormality has not changed in size or appearance. However, there is limited evidence to support the category 3 recommendation, and researchers in recent years have started to question whether the frequent follow-up is necessary.

Yasmeen and her colleagues examined the incidence of breast cancer among 58,408 postmenopausal women who underwent screening mammograms at 40 centers around the country as part of the Women's Health Initiative. The UC Davis study is the largest published study so far to examine the frequent follow-up issue.

Overall, 5.2% - or 2,927 - of the women in the study had probably benign mammogram results. ...