Reducing Number of Patient Visits and Time to Biopsy After Suspicious Breast MRI

The annual volume of breast MRI examinations at our institution increased from 395 in 2014 to 766 in 2018. Accordingly, the annual volume of MRI-guided breast biopsies increased from 41 in 2014 to 102 in 2018. These increases paralleled trends in the community setting over the past 15 years [ 1 Stout N.K. Nekhlyudov L. Li L. et al. Rapid increase in breast magnetic resonance imaging use: trends from 2000 to 2011. JAMA Intern Med. 2014; 174: 114-121 Google Scholar ]. At our institution, a suspicious breast MRI finding would proceed to MRI-directed ultrasound, followed by ultrasound- or MRI-guided core biopsy at a separate appointment, requiring three separate visits. If MRI-guided breast biopsy was necessary, only two appointments were available per week. The increases in breast MRI and MRI-guided biopsy volume resulted in increasing wait times to tissue diagnosis. The time to biopsy after the initial diagnostic breast MRI averaged several weeks, which was excessively lengthy for patients at high risk of developing breast cancer, with a new breast cancer diagnosis, or who traveled long distances to obtain care at our tertiary care center.