Follow-up as an alternative to biopsy for probably benign mammographically detected abnormalities.
As utilization of mammographic screening increases, a large number of probably benign mammographic abnormalities are being reported. Although the primary effort of screening mammography is to detect cancer at its earliest stages, the secondary goal must be to recognize probably benign abnormalities as such and to offer prudent alternative strategies to surgical excision. Retrospective studies of false-negative mammographic findings indicated the potential for increased sensitivity of employing subthreshold findings. But this increased sensitivity is at a high cost of appropriated resources. Other retrospective studies suggested that such increased sensitivity may not be translated to improved clinical outcome. The validity of mammographic surveillance as opposed to immediate surgical referral is best evaluated through prospective trials. Three such trials have been published in the past year and offer strong reason to consider surveillance, under appropriate circumstances, as an acceptable alternative to immediate biopsy for probably benign mammographically detected lesions.