Follow-up imaging of breast symptomatic patients: a waste of radiologist time?

Introduction

The NHSBSP does not recommend early recall following assessment of screen-detected abnormalities. Symptomatic patients in our breast clinic may be invited to return for repeat imaging. A survey of repeat imaging in our symptomatic breast clinic was undertaken to understand whether we can justify reducing the number of patients recalled and to gauge associated anxiety levels.

Methods

We identified 71 consecutive patients attending an imaging appointment from 1 February 2013 who had a repeat imaging recommendation. Patients were asked to complete a questionnaire. We recorded reason for recall, imaging interval, imaging outcome, and feedback from questionnaires.

Results

One patient did not attend. Mean interval between initial and repeat imaging: 4−16 weeks. Fifty-five episodes classified R1/R2 at initial imaging; 11 R3; four R4. Outcomes: 68 % were discharged; 11 % were invited for a third imaging appointment and all were then discharged; 13 % had a benign biopsy; 7 % returned to the surgical clinic for management of their benign symptom. Twenty-three questionnaires were completed − one patient was 'very anxious' about repeat imaging, seven patients were 'mildly anxious', 10 were 'relieved', six were 'not bothered'.

Conclusion

Repeat imaging did not yield any diagnoses of malignancy. All patients were eventually discharged with a benign outcome. We can justify reducing follow-up imaging of our symptomatic patients in line with guidelines for screening assessments. Radiologist time may be better directed towards meeting the symptomatic breast 2-week wait standard.