MANAGEMENT OF PROBABLY BENIGN BREAST-LESIONS

Several large-scale prospective clinical studies establish the validity of managing probably benign breast lesions with periodic mammographic surveillance as a safe and effective alternative to immediate tissue diagnosis. This article describes and illustrates the mammographic features of probably benign lesions, how to conduct the initial imaging evaluation of these lesions, how to implement a program of periodic mammographic surveillance, and what to do when surveillance is not practical. Additional discussion is provided on as yet unresolved issues concerning the diagnosis and management of probably benign lesions, including whether initial full problem-solving imaging should be performed in all cases, whether to use patient age and lesion size (for solitary masses) as additional criteria in deciding between the management alternatives of mammographic follow-up and immediate tissue diagnosis, and what should be the specific timing, frequency, and duration of the follow-up examinations that constitute the surveillance protocol.