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

Brawarsky, Phyllis; Neville, Bridget A.; Fitzmaurice, Garrett M.; Hassett, Michael J.; Haas, Jennifer S.

doi:10.1007/s11606-011-1918-z

Cited by 16 publications

(10 citation statements)

References 33 publications

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“…We also examined if monitoring was influenced by clinical characteristics: only radiotherapy was found to be related with regular FU ( P =.02). This relationship has been previously reported . Other factors were also found to decrease regular monitoring such as older age, long interval after primary BC, high stage of primary cancer, and mastectomy (versus breast conservative treatment) .…”

Section: Discussionsupporting

confidence: 83%

“…This relationship has been previously reported . Other factors were also found to decrease regular monitoring such as older age, long interval after primary BC, high stage of primary cancer, and mastectomy (versus breast conservative treatment) . These factors were expectedly not observed in the present cohort of relatively young patients with very good prognosis, due to inclusion criteria in the GynecoMed network, and long delay before patient's inclusion in the network (median: 4.7 years) thus excluding all patients who had a disease recurrence before their inclusion, and selecting patients with excellent prognosis.…”

Section: Discussionsupporting

confidence: 79%

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Pattern of relapse in low-risk breast cancer patients followed within a community care network

Agopian¹,

Dubot

Houzard³

et al. 2017

Breast J

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International guidelines have set the frame and methods of patients' surveillance after early breast cancer (BC) treatment. Since 1998, delegation of low-risk BC patients follow-up to nonhospital practitioners has been developed within a care network in the Paris region. We used the Gynecomed care network digital database to describe the characteristics of oncological events which occurred in the cohort, and to assess the quality of BC follow-up in relapsing patients. Events were defined as any local, contralateral, or metastatic recurrence, as well as second cancer or death due to any cause. We developed a ranked evaluation method of our surveillance program. Among the 3019 patients followed in the network, 116 (4.3%) patients had 116 events. Median follow-up was 7.1 years (0-51). First events were local-regional relapses, contralateral BCs, metastatic events, second primaries in respectively 52, 26, 14, 24 cases. During the first 5 years, 68.4% of surveillance visits were performed on time, 13.5% were behind schedule and 18.1% were not performed, while 79.1% of mammographies were performed on time, 7.7% behind schedule, and 13.2% were not performed. On schedule examinations allowed diagnosis of 77% of the local-regional, ipsilateral relapses or contralateral BCs, including 38 (69%) discovered by mammographies and 17 (31%) by clinical examination. A nonhospital practitioner care network is able to comply with good surveillance practices and deliver high quality surveillance, in accordance with international guidelines. Delegation of low-risk BC surveillance to nonhospital practitioners is reliable.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 79%

Pattern of relapse in low-risk breast cancer patients followed within a community care network

Agopian¹,

Dubot

Houzard³

et al. 2017

Breast J

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“…We identified hospitalizations in the year before the index mammogram based on the presence of any inpatient claims. Similar to prior studies (Brawarsky et al, 2012; Earle et al, 2003; Kronman et al, 2008; Schootman et al, 2008), we identified primary care visits in the year before the index mammogram based on the presence of claims in the Carrier file with Healthcare Financing Administration codes: 01 (general practice), 11 (internal medicine), 08 (family practice), 16 (obstetrics/gynecology), 38 (geriatric medicine), and 70 (multispecialty group practices).…”

Section: Methodsmentioning

confidence: 99%

Multilevel factors associated with long-term adherence to screening mammography in older women in the U.S.

Hubbard

O’Meara

Henderson

et al. 2016

Preventive Medicine

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In the U.S., guidelines recommend that women continue mammography screening until at least age 74, but recent evidence suggests declining screening rates in older women. We estimated adherence to screening mammography and multilevel factors associated with adherence in a longitudinal cohort of older women. Women aged 66–75 years receiving screening mammography within the Breast Cancer Surveillance Consortium were linked to Medicare claims (2005–2010). Claims data identified baseline adherence, defined as receiving subsequent mammography within approximately 2 years, and length of time adherent to guidelines. Characteristics associated with adherence were investigated using logistic and Cox proportional hazards regression models. Analyses were stratified by age to investigate variation in relationships between patient factors and adherence. Among 49,775 women, 89% were adherent at baseline. Among women 66–70 years, those with less than a high school education were more likely to be non-adherent at baseline (odds ratio [OR] 1.96; 95% confidence interval [CI] 1.65–2.33) and remain adherent for less time (hazard ratio [HR] 1.41; 95% CI 1.11–1.80) compared to women with a college degree. Women with ≥1 versus no Charlson co-morbidities were more likely to be non-adherent at baseline (OR 1.46; 95% CI 1.31–1.62) and remain adherent for less time (HR 1.44; 95% CI 1.24–1.66). Women aged 71–75 had lower adherence overall, but factors associated with non-adherence were similar. In summary, adherence to guidelines is high among Medicare-enrolled women in the U.S. receiving screening mammography. Efforts are needed to ensure that vulnerable populations attain these same high levels of adherence.

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“…Studies in Medicare beneficiaries indicate that 77–91% of breast cancer survivors undergo mammography after diagnosis and that the rates of mammography wane over time and with increasing age. 30,31 Having regular follow-up with providers is also associated with higher rates of surveillance mammography. 31 …”

Section: Current Recommendations For Surveillance Mammography In Oldementioning

confidence: 99%

“…30,31 Having regular follow-up with providers is also associated with higher rates of surveillance mammography. 31 …”

Section: Current Recommendations For Surveillance Mammography In Oldementioning

confidence: 99%

Surveillance Mammography in Older Patients With Breast Cancer—Can We Ever Stop?

et al. 2017

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Importance Approximately 4–5% of breast cancer survivors will develop a new ipsilateral or contralateral cancer (“in-breast event”) over the 5 years following diagnosis, and annual surveillance mammography is recommended for those with residual breast tissue. The risk for such in-breast events persists over time, though increasing age at cancer diagnosis and treatment with hormonal therapy are associated with lower risk, and most older breast cancer survivors will ultimately die from non-breast cancer related causes. Specific guidelines for surveillance strategies in older patients are limited. Prospective data on the benefits and harms of surveillance mammography in this population are lacking, and most of the evidence is derived from observational, retrospective data, often in the general population. Observations We review the current recommendations for breast cancer screening and surveillance for older patients, the current evidence for ipsilateral and contralateral breast cancer risks in older breast cancer survivors, and suggested approaches for discussions about surveillance mammography with older patients. We recommend individualized decision-making for surveillance breast imaging in older breast cancer survivors, with consideration of the following strategy for women age ≥70: one-time imaging 6–12 months after completion of local therapy followed by annual or biennial surveillance mammography for healthy women and cessation of mammography in patients whose life expectancy is <5–10 years, regardless of age. Decisions on mammographic surveillance should also incorporate whether hormonal therapy is being administered, whether one’s anticipated life expectancy is extraordinary, and whether one’s individual risk for in-breast events is higher (or lower) than for average-risk breast cancer survivors. Conclusions and Relevance We propose re-framing discussions around surveillance mammography in older breast cancer survivors and to consider cessation, while taking into account life expectancy, the estimated risk for subsequent in-breast events and patient preferences.

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

Cited by 16 publications

References 33 publications

Pattern of relapse in low-risk breast cancer patients followed within a community care network

Pattern of relapse in low-risk breast cancer patients followed within a community care network

Multilevel factors associated with long-term adherence to screening mammography in older women in the U.S.

Surveillance Mammography in Older Patients With Breast Cancer—Can We Ever Stop?

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