Timely Follow-up Among Multicultural Women With Abnormal Mammograms

Arnsberger, Pamela; Fox, Patrick J.; Ryder, Priscilla T.; Nussey, Brenda; Zhang, Xiulan; Otero-Sabogal, Regina

doi:10.5993/ajhb.30.1.5

Cited by 23 publications

(17 citation statements)

References 13 publications

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“…30 A recent study has shown a positive correlation between increased anxiety and decreased time to cancer diagnosis, thus implying that those patients with increased anxiety are less likely to participate in a treatment strategy that would involve a delay in diagnosis. 31 This finding supports our study, where a greater disutility (patient anxiety) of waiting for SLN biopsy results was positively correlated with the immediate intraoperative results rendered by the TIC strategy.…”

Section: Discussionsupporting

confidence: 81%

Is intraoperative touch imprint cytology of sentinel lymph nodes in patients with breast cancer cost effective?

Jeruss¹,

Hunt²,

Xing³

et al. 2006

Cancer

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BACKGROUND.Sentinel lymph nodes (SLNs) are generally evaluated postoperatively, requiring 5–7 days for assessment. SLNs can also be evaluated intraoperatively by using touch imprint cytology (TIC), thus providing the surgeon immediate feedback and allowing for concurrent completion node dissection (CND) for positive SLNs. The authors hypothesized that TIC, when compared with standard postoperative SLN assessment alone, would permit a cost‐effective evaluation of SLNs in patients with clinically node‐negative breast cancer.METHODS.A decision‐analysis model was created to compare TIC with standard postoperative SLN assessment alone. Sensitivity and specificity of TIC were determined prospectively from 342 patients who underwent SLN biopsy assessed by both techniques. Short‐term health states associated with surgical staging were defined, and utilities were estimated using EuroQol‐5D. Base‐case analysis was performed to estimate quality‐adjusted life years and the incremental cost‐effectiveness ratio. Sensitivity analyses were performed to examine stability of model parameters.RESULTS.For each tumor stage, TIC was cost effective, and for patients with larger tumors (T3 and T4), TIC was the dominant strategy. The analysis was robust to changes in sensitivity and specificity of TIC, prevalence of metastasis, probability of complications, and cost. However, when utility associated with standard SLN assessment was 0.9 or greater, this became the preferred strategy.CONCLUSIONS.TIC is cost effective for assessing SLN metastasis intraoperatively. For patients with larger tumors, it is not only more effective, but also less costly than standard SLN assessment alone. TIC may be particularly useful for patients who experience significant anxiety while awaiting results of standard SLN assessment. Cancer 2006. © 2006 American Cancer Society.

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Section: Discussionsupporting

confidence: 81%

Is intraoperative touch imprint cytology of sentinel lymph nodes in patients with breast cancer cost effective?

Jeruss¹,

Hunt²,

Xing³

et al. 2006

Cancer

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“…One national U.S. organization has undertaken to measure such timeliness as part of a quality assurance program ( 3 ) and is accumulating data, albeit using a self-selected group of reporting institutions. Reports are limited in regard to follow-up after screening, with most being issued from single institutions, some from regional data collection, and others reporting the effect of interventions in this process (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). We undertook this study because the current literature lacks a broad profi le of facility timeliness measures in regard to the additional evaluation of patients with screening-detected abnormalities.…”

Section: Breast Imaging: Timeliness Of Follow-up After Abnormal Screementioning

confidence: 99%

“…Image-guided needle biopsy logistics are therefore likely to be simpler. There are several primarily singlefacility publications ( 5,8,13,14,16,27 ) in which timeliness of follow-up after a screening mammogram is reported by using a variety of methods and definitions. In these publications, the mean or median follow-up times for AI of 10-21 days and for BSC of 10-35 days are reported.…”

Section: Breast Imaging: Timeliness Of Follow-up After Abnormal Screementioning

confidence: 99%

Timeliness of Follow-up after Abnormal Screening Mammogram: Variability of Facilities

Rosenberg¹,

Haneuse

Geller

et al. 2011

Radiology

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Purpose:To describe the timeliness of follow-up care in communitybased settings among women who receive a recommendation for immediate follow-up during the screening mammography process and how follow-up timeliness varies according to facility and facility-level characteristics. Materials and Methods:This was an institutional review board-approved and HIPAA-compliant study. Screening mammograms obtained from 1996 to 2007 in women 40-80 years old in the Breast Cancer Surveillance Consortium were examined. Inclusion criteria were a recommendation for immediate follow-up at screening, or subsequent imaging, and observed follow-up within 180 days of the recommendation. Recommendations for additional imaging (AI) and biopsy or surgical consultation (BSC) were analyzed separately. The distribution of time to follow-up care was estimated by using the Kaplan-Meier estimator. Results:Data were available on 214 897 AI recommendations from 118 facilities and 35 622 BSC recommendations from 101 facilities. The median time to subsequent follow-up care after recommendation was 14 days for AI and 16 days for BSC. Approximately 90 % of AI follow-up and 81% of BSC follow-up occurred within 30 days. Facilities with higher recall rates tended to have longer AI follow-up times ( P , .001). Over the study period, BSC follow-up rates at 15 and 30 days improved ( P , .001). Follow-up times varied substantially across facilities. Timely follow-up was associated with larger volumes of the recommended procedures but not notably associated with facility type nor observed facility-level characteristics.

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“…Finally, patient-related fears and concerns may contribute to delays in appropriate follow-up evaluations and treatments. 20,21,32,[36][37][38][39][40][41][42] In order to successfully implement interventions that overcome such barriers, the emerging consensus is that such initiatives need to be culturally tailored to the specific group of individuals in need. [43][44][45][46][47] Interventions should also involve the local community and should be related to each aspect of the described barriers that may be contributing to the delays in follow-up.…”

Section: Figmentioning

confidence: 99%

Racial/Ethnic Disparities in Time to Follow-Up after an Abnormal Mammogram

Press

Carrasquillo

Sciacca³

et al. 2008

Journal of Women's Health

140

111

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Background: Although non-Hispanic white women have an increased risk of developing breast cancer, the disease-specific survival is lower for African American and Hispanic women. Little is known about disparities in follow-up after an abnormal mammogram. The goal of this study was to investigate potential disparities in follow-up after an abnormal mammogram. Methods: A retrospective cohort study of 6722 women with an abnormal mammogram and documented follow-up from January 2000 through December 2002 was performed at an academic medical center in New York City. The outcome was the number of days between the abnormal mammogram and follow-up imaging or biopsy. Cox proportional hazards models were used to assess the effect of race/ethnicity and other potential covariates. Results: The median number of days to diagnostic follow-up after an abnormal mammogram was greater for African American (20 days) and Hispanic (21 days) women compared with non-Hispanic white (14 days) women (p Ͻ 0.001). Racial/ethnic disparities remained significant in a multivariable model controlling for age, Breast Imaging Reporting and Data System (BIRADS) category, insurance status, provider practice location, and median household income. Conclusions: After an abnormal mammogram, African American and Hispanic women had longer times to diagnostic follow-up compared with non-Hispanic white women. Future efforts will focus on identifying the barriers to follow-up so that effective interventions may be implemented.

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Timely Follow-up Among Multicultural Women With Abnormal Mammograms

Cited by 23 publications

References 13 publications

Is intraoperative touch imprint cytology of sentinel lymph nodes in patients with breast cancer cost effective?

Is intraoperative touch imprint cytology of sentinel lymph nodes in patients with breast cancer cost effective?

Timeliness of Follow-up after Abnormal Screening Mammogram: Variability of Facilities

Racial/Ethnic Disparities in Time to Follow-Up after an Abnormal Mammogram

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