Patient compliance with recommended follow-up after fine-needle aspiration biopsy of solid breast masses

Any needle biopsy procedure is associated with a false-negative rate; therefore, masses diagnosed as benign by needle biopsy should be followed to confirm their stability. This study determines patient compliance with recommended 6-month follow-up of breast masses that have had benign cytology.

This study consists of a retrospective 5-year chart review from August 1994 to August 1999. The study includes patients who had an ultrasound-guided fine-needle aspiration biopsy of a solid breast mass diagnosed as benign and were told to return in 6 months for follow-up. Patients who had the masses surgically removed were excluded. Patients who did not follow-up within a 1-year period were sent a letter of reminder.

Over the 5-year period, a total of 462 patients had an ultrasound-guided fine-needle aspiration biopsy of a solid breast mass diagnosed as benign and were instructed to return at 6 months for follow-up. Two hundred ninety-six (64%) of these patients returned for follow-up within 1 year. The remaining 166 patients were sent a letter of reminder. Of these 166 patients, 71 (43%) responded to the letter; 5 patients were lost to follow-up because they had moved. Of all 462 patients, 367 (79%) eventually returned for follow-up, at an average of 9.2 months after biopsy.

Over a 5-year period, 296 out of 462 (64%) patients were compliant with recommendations for follow-up, and an additional 71 patients responded to a letter of reminder. Noncompliance with recommended follow-up could lead to a delay in diagnosis of false-negative lesions. This study demonstrates the need for radiologists to have a system to track compliance.