FOLLOW-UP PROTOCOL OF PATIENTS WITH NEGATIVE FINDINGS OR NON-PALPABL BENIGN BREAST LESIONS: MAMOGRAPHIC AND ULTRASONOGRAPHIC BI-RADS ASSESSMENT AND ULTRASONOGRAPHY GUIDED FINE NEEDLE ASPIRATION BIOPSY

BACKGROUND: The purpose of this investigation was to analyze the natural course and optimum follow-up protocols of benign characterized nonpalpable breast lesions or the cases with negative mammographic or ultrasonographic (US) fi ndings initially by evaluating with US and/or mammography.MATERIALS AND METHODS: 167 patients those have been followed by our clinic between 1998-2004 were included in this study. The mean age was 44,8. The patients were evaluated by physical examination, diagnostic mammography (above 35 years old) and ultrasonography (all patients) in the fi rst admittance. Biopsy was applied to 66 patients (39.5%) totally. Patients were classifi ed according to breast imaging reporting and data system (BI-RADS) and a certain follow-up protocol was initiated.RESULTS: In the cases ( 10,8 %) in whom benign calcifations were detected in their fi rst admittance, no changes in the calcifations were observed in 91,6 %. In 0,6 %, calcifations disappeared. In 25,2 % of the cases in whom mass was detected initially; the masses resolved in 22 %, remained same in 65 % and increased in size in 13 % in the fi nal evaluation. After the fi rst admittance, it was seen that menopause, oral contraceptives and hormone replacement therapy didn’t aff ect the BI_RADS progression statistically. Benign pathological fi ndings were obtained in 100 % of US guided fi ne needle aspiration biopsies (FNAB) applied to BI-RADS 2 (n=58) and 3 (n=6) groups.CONCLUSIONS: Although in the follow-ups of the most of the patients with benign nonpalpable breast lesions or with negative mammographic and/or ultrasonographic lesions, clinical fi ndings remain the same, nearly half of the patients are subjected to biopsy in any time of their follow-up period. We think US guided FNAB is safe and reliable. On the other hand, mammographic and ultrasonographic BI-RADS can be evaluated together in the routine follow- ups of the patients with negative or benign fi ndings without biopsy relaibly in this manner.