BACKGROUND: Breast atypia increases overall breast cancer risk, potentially necessitating future interventions. This study examines the frequency and outcomes of additional percutaneous biopsies after an atypia diagnosis. METHODS: Adult patients with breast atypia (atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ) at a single institution were reviewed for subsequent core needle biopsies (CNBs) and corresponding malignant outcomes. RESULTS: Among 432 patients, median age at diagnosis was 54.8 y. Seventy-one (71/432, 16.4 %) patients developed a breast malignancy. During a median follow-up of 7.4 y, 113 patients underwent 149 additional CNBs. Twenty-six patients (26/113, 23.0 %) had >
2 additional CNBs. Approximately half (79/149, 53.0 %) of all additional CNBs occurred within 5 years after breast atypia diagnosis. CONCLUSION: A considerable number of patients with breast atypia undergo additional percutaneous biopsies, especially within 5 years post-atypia diagnosis. Our study highlights the significant burden of surveillance and the need for tailored follow-up strategies.