Purpose: To determine whether lesion size and patient age should prompt immediate biopsy of selected nonpalpable, circumscribed, noncalcified solid (probably benign) breast masses, which otherwise would be managed with periodic mammographic surveillance.
Materials and methods: Consecutive cases of probably benign breast masses were studied, for which mammographic surveillance was recommended prospectively. Patient age and lesion size were recorded, but age and size thresholds were not used as eligibility criteria. Clinical outcome, determined for each patient after 3 or 3 1/2 years of surveillance, was evaluated as a function of patient age and lesion size.
Results: There were 1,403 study cases, among which 19 cancers were diagnosed (positive predictive value [PPV] = 1.4%). Only small differences were found in PPV for various patient-age and lesion-size subgroups. Even the subgroup with the highest PPV, which consisted of women aged 50 years and older, contained 60 benign masses for each cancer.
Conclusion: Nonpalpable, circumscribed, noncalcified (probably benign) breast masses should be managed with periodic mammographic surveillance regardless of lesion size and patient age.