Underutilization of Mammography in Older Breast Cancer Survivors

Schapira, Marilyn M.; McAuliffe, Timothy L.; Nattinger, Ann B.

doi:10.1097/00005650-200003000-00005

Cited by 98 publications

(88 citation statements)

References 32 publications

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“…This finding about BCS only, consistent with other studies of women with DCIS or early stage invasive cancer, is a further cause for concern. 21,23,33 Over 25% of our subjects had BCS without RT and although there are a number of clinical factors associated with recurrence or invasive breast cancer after DCIS, [34][35][36] studies have found risks to generally be lower for women treated with BCS and RT opposed to BCS alone. 1,2,16,37,38 Lower screening among women with mastectomy is also problematic as women with DCIS are at higher risk for a second cancer in the opposite breast.…”

Section: Discussionmentioning

confidence: 95%

“…22 We examined use of initial mammography within the first interval and continuing "annual" mammography for three and five surveillance intervals. Because Medicare claims may not reliably differentiate between surveillance and diagnostic exams for women with DCIS, 10,23 we assessed whether a women had at least one mammogram during each of the specified surveillance intervals. The sample of women who were eligible to receive an initial mammogram was 8,853, and 6,046, and 3,531 respectively for the three and five surveillance intervals.…”

Section: Outcomementioning

confidence: 99%

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Use of Annual Mammography Among Older Women with Ductal Carcinoma In Situ

et al. 2011

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BACKGROUND: As ductal carcinoma in situ (DCIS) is a risk factor for invasive breast cancer, ongoing annual mammography is important for cancer control, yet little is known about racial/ethnic and other disparities in use among older women with DCIS. METHODS: SEER-Medicare data was used to identify women age 65-85 years, diagnosed with DCIS from 1992 to 2005 and treated with surgery, but not bilateral mastectomy. We examined factors associated with receipt of an initial mammogram within 1 year of treatment and subsequent annual mammograms for 3 and 5 years. We examined whether follow-up care, by a primary care physician or cancer specialist, or neighborhood characteristics mediated disparities in mammography use. RESULTS: Overall, 91.3% of women had an initial mammogram. After adjustment, blacks and Hispanics were less likely than whites to receive an initial mammogram (odds ratio (OR) 0.74, 95% confidence interval (CI) 0.55-0.99 and OR 0.65, CI 0.46-0.93, respectively, as were women of lower socioeconomic status (SES), women who had a mastectomy or breast conserving surgery without radiation therapy, and women who did not have a physician visit. Overall rates of annual mammography decreased over time. Disparities by SES, initial treatment type, and physician visit did not diminish over time. Physician visits had a modest effect on reducing initial racial/ethnic disparities. CONCLUSIONS: Annual mammography among women age 65 to 85 with DCIS declines as women get further from diagnosis. Interventions should focus on reducing disparities in the use of initial surveillance mammography, and increasing surveillance over time.KEY WORDS: ductal carcinoma in situ (breast); mammography; disparities.

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Section: Discussionmentioning

confidence: 95%

Section: Outcomementioning

confidence: 99%

Use of Annual Mammography Among Older Women with Ductal Carcinoma In Situ

et al. 2011

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“…Previous studies have reported underuse of surveillance mammography by breast cancer survivors. 20 -22 Schapira et al 20 found that only 62% of Medicare beneficiaries had annual mammography claims during the first 2 years after initial treatment of early breast cancer. Our study found higher rates but the inclusion of multiple years of follow-up demonstrated a steady decline over time.…”

Section: Discussionmentioning

confidence: 99%

“…20 -23 In addition, little is known regarding factors associated with the use of mammography in this population, especially in settings in which health insurance is not a barrier. Previous studies examining the use of mammography among breast cancer survivors have focused mainly on Medicare beneficiaries, 20 or in single regions in the U.S. 21,23 Enrollees of integrated health systems have healthcare insurance that includes mammography as a covered benefit and include women younger than those typically enrolled in Medicare. Therefore, integrated health systems provide a unique setting to examine factors associated with the use of mammography that is independent of the effects of health insurance.…”

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confidence: 99%

Patterns and predictors of mammography utilization among breast cancer survivors

Doubeni

Field

Yood

et al. 2006

Cancer

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BACKGROUND: Improvements in cancer detection and treatment have resulted in increasing numbers of breast cancer survivors. Information regarding the use of mammography by breast cancer survivors is limited. METHODS: The use of surveillance mammography was examined over a 5-year period in a retrospective cohort of women age\u3eor=55 years who were diagnosed with incident primary breast cancer (1996-1997) while enrolled in 1 of 4 geographically diverse integrated health systems. RESULTS: Of the 797 women included in the study, 80% (n=636) underwent mammograms during the first year after treatment for breast cancer. The percentage of women having mammograms during each yearly period decreased significantly over time. In multivariable analyses, older women with comorbid illnesses or those with late-stage disease were less likely to undergo mammograms, whereas those who underwent breast-conserving therapy (adjusted odds ratio [OR] of 1.38 [95% confidence interval (95% CI), 1.09-1.75]) were more likely to have mammograms. Women who had outpatient visits with a gynecologist (adjusted OR of 3.49 [95% CI, 2.55-4.79]), or a primary care physician (adjusted OR of 2.21 [95% CI, 1.73-2.82]) during the year were more likely to undergo mammograms in that year. CONCLUSIONS: The use of mammography among breast cancer survivors declines over time. Efforts are needed to increase awareness among healthcare providers and breast cancer survivors of the value of follow-up mammography. The current findings highlight the importance of maintaining ongoing contact with primary care physicians and gynecologists

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“…12,13 Mammography surveillance in breast cancer follow-up has been shown to be underutilised, with the proportion of patients receiving a contralateral mammography varying from 80% in the first year to 60% in the fifth year of follow-up. [14][15][16] This study was designed to evaluate the diagnostic value of annual surveillance mammography and its impact on survival. In addition, the compliance with annual mammography was evaluated in MCBC patients, as was its potential impact on the diagnostic performance of mammography and MCBC patient survival.…”

Section: Introductionmentioning

confidence: 99%

The value of surveillance mammography of the contralateral breast in patients with a history of breast cancer

Lu¹,

Schaapveld²,

Jansen³

et al. 2009

European Journal of Cancer

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The value of surveillance mammography of the contralateral breast in patients with a history of breast cancer Lu, W.L.; Schaapveld, M.; Jansen, L.; Bagherzadegan, E.; Sahinovic, M.M.; Baas, P.C.; Hanssen, L.M.H.C.; van der Mijle, H.C.J.; Brandenburg, J.D.; Wiggers, T. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Results: The cumulative MCBC incidence rate at year 10 was 3.4% (95% CI: 2.8-4.0%). The programme sensitivity of surveillance mammography was 59.6% (95% CI: 50.6-68.7). In patients who complied with annual mammography, sensitivity was increased to 70.8% Conclusion: Mammography is a valuable tool for the early detection of MCBC during hospital follow-up of breast cancer patients and is probably beneficial to survival. The utilisation of follow-up surveillance in breast cancer patients and its potential impact on survival deserve further investigation.

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Underutilization of Mammography in Older Breast Cancer Survivors

Cited by 98 publications

References 32 publications

Use of Annual Mammography Among Older Women with Ductal Carcinoma In Situ

Use of Annual Mammography Among Older Women with Ductal Carcinoma In Situ

Patterns and predictors of mammography utilization among breast cancer survivors

The value of surveillance mammography of the contralateral breast in patients with a history of breast cancer

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