Follow-up Protocol for BI-RADS 3 Classification

Initial Follow-up Protocol

For patients with a BI-RADS 3 classification, the National Comprehensive Cancer Network recommends diagnostic mammograms at 6 months initially, then every 6 to 12 months for a total of 1 to 2 years 1, 2
At the first 6-month follow-up, a unilateral mammogram of the index breast should be performed, according to the National Comprehensive Cancer Network 3, 4
For women aged 40 years and older, the 12-month study should be bilateral to ensure the contralateral breast is imaged at appropriate yearly intervals, as recommended by the National Comprehensive Cancer Network 3, 5
Depending on the level of concern, subsequent follow-up may be either every 6 months for the breast in question 5 or annual bilateral mammograms, as recommended by the National Comprehensive Cancer Network 3, 1

If the lesion remains stable or resolves mammographically during the follow-up period, the patient should resume routine screening intervals for mammography, according to the National Comprehensive Cancer Network 1, 2
If any interval mammogram shows that the lesion has increased in size or its benign characteristics have changed, a biopsy should be performed, as recommended by the National Comprehensive Cancer Network 3, 1

Initial biopsy with histologic sampling may be a reasonable alternative to short-term follow-up in certain situations, such as when a return visit is uncertain, the patient is highly anxious, or the patient has a strong family history of breast cancer, according to the National Comprehensive Cancer Network 5, 3
When the patient strongly desires biopsy, initial biopsy with histologic sampling may also be considered, as recommended by the National Comprehensive Cancer Network 1, 2

After completion of the 1-2 year follow-up period with stable findings, the patient should return to routine screening, according to the National Comprehensive Cancer Network 3, 1
If pathology and imaging findings are concordant after any biopsy, follow-up with mammography every 6 to 12 months for 1 to 2 years is recommended before returning to routine screening, as recommended by the National Comprehensive Cancer Network 1, 2