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PubMed2001

Screening mammographies in Switzerland: what makes female and male physicians prescribe them?

QUESTION UNDER STUDY: Physicians play a key role in motivating women to undergo mammography screening. In 1998 we assessed Swiss physicians' attitudes to mammography screening and their prescription behaviour in this regard. METHODS: All female physicians and every second male physician aged 50-69 who were either not board-certified or board-certified in general practice, internal medicine, or obstetrics/gynaecology were sent a questionnaire. The response rate was 50% and thus 738 questionnaires were included in this study. Of the study population 39% were female and 61% male physicians. The distribution of professional backgrounds was: 27% board-certified general practitioners; 23% board-certified internists; 11% board-certified gynaecologists; 39% not board-certified. RESULTS: 55% of all study participants were in favour of a mammography screening programme for women aged over 50 in Switzerland, but breast self-examination and clinical breast examination were judged to have a more positive impact on breast cancer survival. Among clinically practising physicians, 22% reported generally prescribing biannual screening mammographies for women aged 50-69. Irrespective of other determinants, physicians from the Italian- and French-speaking parts of Switzerland prescribed screening mammographies more often than their colleagues from the German-speaking part (odds ratio [OR] 2.5; 95% confidence interval [CI] 1.5-4.2). Clinical practice in obstetrics/gynaecology (OR 2.4; CI 1.3-4.2) and a self-reported high level of knowledge concerning mammography screening (OR 1.9; CI 1.1-3.2) were also positively associated with the prescription of screening mammography. CONCLUSIONS: Since mammography screening programmes exist in only three French-speaking cantons of Switzerland (VS; VD; GE), the gap in prescription of screening mammographies between French/Italian- and German-speaking regions must be narrowed to prevent a higher prevalence of side effects from opportunistic screening among German-speaking women. There is a need to educate physicians and the political community regarding the risks and benefits of mammography screening.

Aged↗
PubMed2001

[Referrals to clinical mammography in a county without screening program].

Systematic mammography-screening may reduce the number of unindicated diagnostic mammographies. Six thousand, eight hundred and four women from Rosklde County underwent mammography at the Roskilde County Hospital over a four-year-period. Five hundred and nineteen women were excluded from the study, leaving 6285 women to form the study population. Twenty-four percent of the women had no clinical indication for mammography, 15% of the women had an increased risk of breast cancer, and for 61% of the women there was a clinical indication for mammography. Breast cancer was found in 0.46% of the women undergoing mammography without a clinical indication, in 1.2% of the women belonging to risk-groups, and in 8.9% of the women with a clinical indication for mammography. Biennial screening for breast cancer of 15,394 women (7697 women a year) in the age group 50-69 years could reduce the number of diagnostic mammographies by 338 women a year. Cooperation with GPs in a reduction of unindicated clinical mammographies of women younger than 50 years could reduce the number by a further 171 women. Potential savings in the X-ray-departments is not a weighty argument in favour of introduction of mammography screening.

Adult↗
PubMed1992

Quality assurance in mammography. Accreditation, legislation, and compliance with quality assurance standards.

The status of mammography quality assurance in the United States has been reviewed briefly. The history, goals, current status, and possible future directions of the ACR Mammography Accreditation Program have been described, and other ACR activities in mammography quality assurance have been discussed, including ACR Standards of Practice in Mammography, ACR Mammography Quality Control Manuals, and the ACR/CDC Cooperative Agreement on Quality Assurance in Mammography. The quality assurance provisions of recently adopted federal legislation on mammography have been reviewed, including the Medicare legislation on screening mammography, along with the proposed Women's Health Equity Act mammography quality assurance provisions. Finally, a simple plan has been proposed to fuse these activities into a coherent program for ensuring consistently high quality mammography at every site in the United States.

Accreditation↗
PubMed1991

Physician recommendations for screening mammography: results of a survey using clinical vignettes.

BACKGROUND: Although experts estimate that 30% of breast cancer deaths could be prevented if women were screened according to published guidelines, fewer than 50% of physicians follow screening mammography guidelines, and fewer than 30% of women are screened with mammography. METHODS: Physician recommendations for screening mammography were examined in a questionnaire mailed to 300 randomly selected physicians of the Ohio Academy of Family Physicians. Physicians responded with their likelihood of recommending screening mammography to 24 clinical vignettes that high-lighted patient, mammographic, and encounter characteristics. RESULTS: Seventy-one percent responded. Ninety-one percent reported almost always recommending screening mammography to a 55-year-old woman at her yearly examination. They were significantly less likely to recommend mammography to women who were young (40 years old), were old (70 years old), were poor, had small breasts, had painful mammograms, did not want the doctor to look for cancer, lived in a nursing home, or were retarded. Physicians recommended mammography less often when the mammography unit was far away or produced poor quality films or ambiguous interpretations. When physicians ran behind schedule, perceived a more urgent medical problem during the encounter, or saw a woman for an acute visit, they recommended mammography significantly less often. CONCLUSIONS: Patient, mammographic, and encounter characteristics significantly limit physician recommendations for screening mammography as assessed by clinical vignettes. These characteristics must be addressed if breast cancer mortality is to be reduced with early screening.

Adult↗
PubMed1997

[Use of screening mammography and its demographic and risk determinants in women 25 to 65 years of age].

BACKGROUND: To know the utilization of the screening mammography among women from 25 to 65 years old in an urban health zone, where there is not an specific screening program for breast cancer. To detect the demographic and risk determinants that are involved in the mammography screening use. SUBJECTS AND METHODS: A sample of 1,240 women were interviewed consecutively as they visited their physician. Risk factors, sociodemographic variables and use of health services were analyzed. The associated variables with the use of mammography screening were determined by univariant analysis. A multiple logistic regression model was designed to identify the variables independently associated with the use of mammography screening. RESULTS: The percentage of interviewed women who have completed at least one mammography screening in the last three years has been 10.2 +/- 3% (confidence level: 95%), 68.3% of them were under 50 years old. The variables independently associated with the use of mammography screening were: age (OR = 1.08); routine visit to the gynecologist (OR = 8.13); educational level (primary: OR = 2.44, secondary: OR = 3.66, university: OR = 7.43, no schooling: reference level); and knowledge about the benefits of mammography screening (OR = 6.15). Family history of breast cancer and the other risk factors were found not to be associated with the use of mammography screening. CONCLUSIONS: The use of mammography screening among women from 25 to 65 years is inadequate according to the age and other risk factors. Mammography screening among women with a family history of breast cancer and those over 50 years old is underused, so it would be recommended and their use increased for these women. But women under 40 years old without family history of breast cancer have to be dissuaded from undertaking such a screening.

Adult↗
PubMed1999

Impact of same-day screening mammography availability: results of a controlled clinical trial.

BACKGROUND: We conducted a prospective controlled clinical trial in an urban academic general medicine practice to test the effect of same-day mammography availability on adherence to physicians' screening mammography recommendations. PATIENTS AND METHODS: Participants were a consecutive sample of 920 female patients aged 50 years or older who had received a physician's recommendation for screening mammography at an office visit and had no active breast symptoms, history of breast cancer, or a mammogram within the previous 12 months. Women were assigned to same-day screening mammography availability (intervention group) or usual screening mammography scheduling (control group). MAIN OUTCOME MEASURES: Three-, 6-, and 12-month rates of adherence to physicians' recommendations for screening mammography. RESULT: Twenty-six percent of women in the intervention group obtained a same-day screening mammogram. At 3 months, 58% of the women in the intervention group underwent the recommended screening mammography compared with 43% of the women in the control group (P<.001), increasing to 61% and 49% at 6 months (P<.001), and 268 (66%) of 408 vs 287 (56%) of 512 at 12 months (P = .003). The difference between the intervention and control groups 3-month adherence rates was most marked among women aged 65 years or older (58% vs 34%; P<.001), women who were not employed (54% vs 36%; P<.001), and women with a history of having had either no mammograms (39% vs 20%; P = .02) or only 1 to 2 mammograms (57% vs 38%; P<.001) within the last 5 years. CONCLUSIONS: Same-day mammography availability increased 3-, 6-, and 12-month screening mammography adherence rates in this urban academic general medicine practice. The effect was most marked among women aged 65 years or older, women who were not employed, and those who had had fewer than 3 mammograms in the last 5 years. The efficacy of this intervention in other settings still needs to be demonstrated.

Academic Medical Centers↗
PubMed1991

The effect of silicone-gel-filled implants on mammography.

Fifty-four women who had previously undergone breast augmentation underwent film-screen mammography using both the standard implant compression technique and, when possible, the implant displacement technique. All had preaugmentation mammography available for evaluation. The area of mammographically visualized breast tissue before and after augmentation mammoplasty was measured using a transparent grid. Patients with subglandular implants had a mean 44% decrease of measurable tissue area with compression mammography and 36% decrease with displacement mammography. Patients with submuscular implants had a mean 25% decrease in measurable tissue area with compression mammography and 15% decrease with displacement mammography. Anterior breast tissue was seen better with displacement mammography, and posterior breast tissue was seen better with compression mammography. Most patients had some degree of parenchymal scarring and lower image quality after augmentation. State-of-the-art mammography was not possible in most patients whose breasts were augmented with silicone-gel-filled implants.

Breast Neoplasms↗
PubMed2002

Increased mammography use and its impact on earlier breast cancer detection in Vermont, 1975-1999.

BACKGROUND: A trend toward earlier breast carcinoma detection in the United States has been attributed to screening mammography, although direct evidence linking this trend to the increased use of mammography in a general population is lacking. This study examined the effects of mammography on tumor size and axillary lymph node metastasis in Vermont over 25 years. METHODS: Pathology and mammography data from 3499 Vermont women who were diagnosed with invasive breast carcinoma during 1975-1984, 1989-1990, and 1995-1999 were compared. Logistic regression analysis was used to estimate the effects of age, mammography use, and period on the odds of a tumor < or = 2 cm and the odds of negative lymph nodes. RESULTS: The proportion of breast tumors that were detected by screening mammography increased from 2% during 1974-1984 to 36% during 1995-1999 (P < 0.001), and these tumors were more likely to measure < or = 2 cm than tumors that were detected by other methods. Among women age > 50 years, the odds ratio (OR) was 4.5, with a 95% confidence interval (95% CI) of 3.5-6.4. The effect was smaller in younger women (OR, 1.8; 95% CI, 1.1-3.0). Mammographic detection increased the odds of negative lymph nodes by a similar amount in both age groups, although women age > 50 years were more likely to have negative lymph nodes than younger women (OR, 1.3; 95% CI, 1.1-1.6). Tumor size and lymph node metastasis also were related to the number of mammograms and to the mammographic interval. CONCLUSIONS: Most of the trend toward earlier detection in Vermont was due to mammography. Mammography had a lesser effect on tumor size among younger women, which may be related to less frequent screening, although its effect on lymph node metastasis was not age dependent. Women age < 50 years were more likely to have positive lymph nodes, independent of the method of detection or the frequency of mammography.

Age Factors↗
PubMed2005

Correlations between access to mammography and breast cancer stage at diagnosis.

BACKGROUND: There is a lack of data on the access to mammography and its relation to the incidence of early breast cancer. In this study, the authors evaluated access by correlating geographically the number of U.S. Food and Drug Administration (FDA)-certified mammography facilities and the AJCC stage of breast cancer at diagnosis by county. METHODS: Breast cancer incidence rates and stage at diagnosis were compared with the number of FDA-certified mammography facilities by county in the Surveillance, Epidemiology, and End Results reporting areas. The objective was to determine whether the number of certified facilities was associated with the percent of breast cancers diagnosed at the in situ stage. This was a multiple-group ecologic study, and counties were used as the units of analysis. RESULTS: There was a strong correlation between the number of mammography facilities and the population of a county, whereas there was no correlation between the number of mammography facilities and the land area of a county. A correlation existed between the percent of incident breast cancers that were diagnosed as in situ disease and the number of mammography facilities per 10,000 women among both whites and African Americans. CONCLUSIONS: There was an association between the number of mammography facilities and population. In counties with >/= 30,000 black and white females, 1) the percent of in situ breast cancers in black women and white women was correlated with the number of facilities per 10,000 women, indicating that population density is a factor in access for both racial groups; 2) except for 2 counties with >/= 30,000 black women, the percent of incident in situ cases was similar in both black women and white women, indicating equal access in both groups; and 3) there was a correlation between the percent in situ incidence and number of facilities per 1000 square miles in white women, but not in black women. There was a direct correlation of statewide mammography rates with the number of facilities per 1000 square miles, indicating that the rate of screening depends on availability. Maximum rates of statewide screening were achieved when there were > 15 mammography facilities per 1000 square miles.

Black or African American↗
PubMed2005

Perceptions of insurance coverage for screening mammography among women in need of screening.

BACKGROUND: Breast carcinoma remains a significant health problem in the U.S., especially among underserved populations. Although screening mammography is recommended for early detection, in 2002, approximately 25% of women age > 40 years had not had a mammogram within the past 2 years. The current study examined perceptions of insurance coverage and cost as barriers to screening mammography within an underserved, predominantly low-income population of women in need of a mammogram. METHODS: Between 1998 and 2002, face-to-face interviews were conducted with 897 women age > or = 40 years. All women were part of a randomized, controlled study evaluating a health education intervention designed to improve mammography screening. They were asked questions at baseline about cost and insurance coverage as barriers to mammography screening. Women's reports of their level of insurance coverage for mammography were compared with actual coverage by their insurance type to determine the accuracy of their perception of insurance coverage for mammography. The relation between perception of insurance coverage and the barrier of cost was investigated. RESULTS: Greater than half of the women who needed a mammogram identified cost as a barrier to mammography; however, 40% of these women had an inappropriate perception of their insurance coverage. Underestimating or not knowing the level of mammography coverage was strongly associated with reporting cost-related difficulty (odds ratio [OR] = 4.57, 95% confidence interval [95% CI], 1.95-10.70 for the underestimate category; OR = 4.42, 95% CI, 1.80-10.88 for the don't know category), regardless of true coverage levels. CONCLUSIONS: Providing women with information regarding their actual coverage for mammograms may reduce the impact of cost as a barrier to screening mammography.

Adult↗
PubMed2000

The impact of medicare funding on the use of mammography among older women: implications for improving access to screening.

BACKGROUND: In 1991, a policy change extended finan cial coverage for biennial mammography to holders of Medicare part B. The impact of this decision on mammography use was examined by comparing mammography use among Medicare-eligible and ineligible women in the years before (1990) and after (1993) the policy change, using National Health Interview Survey (NHIS) data, controlling for socioeconomic indicators and for having a usual source of medical care. METHODS: The Medicare-eligible group consists of 2,419 women ages 65-69 years and women ages 60-64 years who are Medicare-eligible. The Medicare-ineligible group consists of 1,872 women ages 60-64 years. The analysis used logistic regressions and compared women who had undergone mammography in the prior 2 years and controlled for race, ethnicity, socioeconomic status, insurance status, and usual source of care. RESULTS: Medicare reimbursement of mammography appears to have increased the number of Medicare-eligible women who had had a mammogram in the 2 years prior to the survey. However, the analyses suggested that disparities in mammography use due to access to primary care and socioeconomic status persisted after the change in Medicare coverage. Analyses indicated that having additional insurance was the only significant predictor of having a usual source of care among the Medicare population. CONCLUSIONS: This analysis suggests that simply removing financial barriers to mammography for older women (such as the 1998 elimination of a deductible payment for mammograms provided under Medicare) may have limited effectiveness. The strong relationship between having a usual source of care and mammography suggests that disparities in mammography use may reflect inequalities in access to health care in general.

Aged↗
PubMed2005

Screening mammography in Minnesota cancer patients.

BACKGROUND: Although a decrease in mortality due to breast cancer is the most definitive measure to assess the effectiveness of screening mammography, stage at diagnosis is an interim measure. OBJECTIVES: The objectives were to (1) examine the association between screening mammography and cancer stage at diagnosis and (2) provide information about mammography utilization in an insured population diagnosed with cancer. RESEARCH DESIGN: We utilized an existing data set of linked cancer registry-claims data. We computed an odds ratio for the association between screening mammography and breast cancer stage at diagnosis and examined mammography utilization patterns. SUBJECTS: Women in Minnesota with available claims data who developed cancer in 1995. MEASURES: Mammography claims and breast cancer stage at diagnosis (grouped according to AJCC and summary stage). RESULTS: Screening mammography was associated with significantly increased odds of an early (versus late) stage cancer diagnosis, consistent with the goal of screening. Mammography utilization was generally highest in the age group 50-64 and decreased in each successive age group. CONCLUSIONS: Linkage between insurance claims and cancer registry data provides useful information not available in either data set alone. The results contribute to the cohesiveness of the evidence that mammography prevents death due to breast cancer.

Breast Neoplasms↗
PubMed2004

Pain during mammography: the role of coping strategies.

This study examined the pain/discomfort ratings during mammography and their relationship to pain-coping strategies. Prior to their mammogram in order to assess how they cope with day-to-day pain experience 220 women completed an Iranian translation of the Coping Strategies Questionnaire (IR-CSQ). Immediately after mammography, all subjects completed a modified version of the IR-CSQ to assess their coping style with pain during mammography. Ratings of pain/discomfort during the mammogram were also collected, using a 100-mm Visual Analog Scale and a 6-point Pain/Discomfort Rating Scale (PRDS). Up to 92% of the women reported that the mammogram examination was painful. However, considerable variability in pain ratings was found, with some women reporting severe pain and others reporting little or no pain. While the ratings of coping effectiveness in facing day-to-day pain experience were not significantly related to mammography pain ratings, there was a significant association between the ratings of coping efficacy in facing mammography pain specifically and measures of mammography pain. Multiple hierarchical regression analyses revealed that while higher use of catastrophising and coping self-statements in facing mammography pain were predictors of more severe pain during mammography, higher use of ignoring pain sensations was predictive of less severe pain during mammography. The potential significance of these findings for identifying patients at risk of poor adjustment to chronic pain is discussed.

Adaptation, Psychological↗
PubMed1998

What's new in mammography.

Early diagnosis of breast cancer plays the leading role in reducing mortality rates and improving the patients' prognosis: mammography is the most sensitive technique currently available for the detection of nonpalpable lesions and therefore the method of choice. However, mammography has some limitations and the technique must be improved with technological devices without affecting image quality. This could be the target to increase diagnostic accuracy. Mammography sensitivity and specificity are now improved with the digital computer assisted technique, teleradiology, digital tomosynthesis or digital angiography--used to study microvascularization--3D imaging or synchrotron light, and laser mammography. Such other technological devices as Mammospot reduce breast thickness and provide better breast compression. Digital mammography can be carried out with film or direct digitization. The advantages of the digital technique are a shorter examination time, less storage space, electronic image recording, with image 'adjustments' made by the radiologist, and especially computerized analysis. The computer aided diagnosis can be defined as the diagnosis made by the radiologist who considers the results of computerized analysis as a 'second opinion'. In this way incidental mistakes made by radiologists, can be corrected by the computer analysis. Computers are a basic element also in teleradiology, which needs immediate and simultaneous admittance to the patient's history and permits radiology optimization in rural areas too. As for tomosynthesis, it permits to study a single slice of the breast without glandular tissue overlapping, which is useful in dense breasts where the diagnosis can be made with a lower X-ray dose. Moreover, this method fits the current mammographic systems easily. 3D imaging is still a work in progress. Synchrotron mammography is used only on surgery specimens, where it exhibits high resolution and contrast, depicting structures and details missed by conventional mammography. Breast DSA allows the study of vessels < 0.20 mm in diameter and of fine microvascular details; it can also demonstrate neoangiogenesis. Laser mammography permits bilateral examinations of the breast in 10-15 mins and is currently used also for breast cancer therapy, although only in animal trials. To conclude, after reviewing new techniques and evaluating the real cost/benefit ratio for each of them, conventional mammography remains the most sensitive tool for breast cancer diagnosis.

Angiography, Digital Subtraction↗
PubMed1998

Knowledge, perceptions, and mammography stage of adoption among older urban women.

INTRODUCTION: Mammography is under-used among older minority women. Identifying differences in their attitudes and beliefs by stage of mammography adoption will guide interventions for these under-studied and under-served women. METHODS: A total of 253 older urban women were interviewed, assessing breast cancer knowledge, perceived mammography benefits and barriers, stage of mammography adoption, personal experience with breast cancer, physical and cognitive functioning, smoking status, source and frequency of regular medical care, and demographics. Analyses compared scale scores and individual items by stage of mammography adoption. Multivariate analysis used linear and logistic regression with stepwise model selection. RESULTS: Sample mean age was 72.5 years; 88% were African American. About half (52%) had had a mammogram within the past 2 years (i.e., action stage of mammography adoption). Of the rest, 16% were thinking about having a mammogram in the next 6 months (contemplators) and 32% were not thinking about having a mammogram within 6 months (precontemplators). Knowledge and benefit scores were lowest for precontemplators. Overall barrier scores were highest for precontemplators (P < .001), but contemplators were most likely to worry about finding a lump (P < .05). Lower perceived barriers, provider recommendation, regular medical care somewhere other than a private physician's office, and age < 75 years were independently associated with more favorable mammography stage (R2 = .47). CONCLUSION: Mammography interventions for older urban women should combine provider recommendations with barrier-reducing interventions. Knowledge is associated with mammography contemplation, but barriers may affect whether contemplation leads to action. Precontemplators may need explanation of the rationale for screening; contemplators may need intervention to assuage fears.

Age Factors↗
PubMed2003

Does mammography hurt?

The documented incidence of pain associated with screening mammography varies from 1% to 62%. Some researchers suggest that pain may undermine compliance with screening mammography. As a part of a quality improvement project, we have surveyed women undergoing mammography in 2 centers in Jerusalem to identify the prevalence, severity, and duration of mammography-associated pain, demographic risk factors, and the degree that this may undermine compliance with breast cancer screening. A 23-item questionnaire was administered to 399 women (32% at the Shaare Zedek Medical Center [SZMC] and 68% at the Rachel Nash Comprehensive Breast Clinic [HALA]). Of the total, 77% of the women reported that the procedure was painful. Of those reporting pain, 60% described pain intensity as moderate or severe. In 67%, the pain resolved within 10 minutes. By univariate analysis, the only significant predictor for pain during mammography was cyclic breast pain (P = 0.053). No significant correlation was identified for age, breast size, pre-mammography counseling, and examination center (SZMC vs. HALA). The prevalence of pre-mammography counseling or explanation was low (51%). Despite that, 61% of the respondents expected that mammography would be painful. Indeed, most of those who anticipated pain reported that the actual severity was not greater than the anticipated severity. Even among women who reported pain of moderate or greater severity, less than 5% expressed preference to receive pre-emptive analgesia prior to their next mammogram. A substantial minority of women acknowledged that the experience of their mammography invoked reactions that may impend future compliance; 26% reported anxiety and 12% reported pain as factors that may interfere with ongoing compliance with regular mammographic screening. These data serve to emphasize the need for appropriate pre-test counseling and suggest a possible role for post-test debriefing to address those factors which may interfere with future test compliance.

Female↗
PubMed2001

The effect of age and density of the breast on the sensitivity of breast cancer diagnostic by mammography and ultasonography.

PURPOSE: We studied which, age of the patient or density of the breast accounts for the sensitivity of mammography and ultrasonography (US). Furthermore we studied whether the overall impression on the density of the breast or the density in tumour area accounts for the sensitivity of mammography and ultrasonography. MATERIALS AND METHODS: The material consisted of 572 consecutive histologically and 5 cytologically verified breast cancer cases. Mammography and US examinations were performed immediately before breast cancer operations and information on the findings were received from the original patient files and classified as malignant or benign. The density of breast parenchyma to fatty, mixed or dense in total breast and separately in tumour area was defined by a radiologist group from the original mammograms by comparing to model mammograms. The sensitivity (Se) of mammography and US was compared in 3 age groups (26-49, 50-59 and 60-92) and in the different density classes. RESULTS: Sensitivity of mammography increased by age (density-adjusted OR = 0.2, 95%, CI 0.1-0.5) in age group 26-49 compared to age group 60-92) and with fattiness of the breast (age-adjusted OR= 0.4, 95%, CI 0.1-1.0 for dense breast parenchyma in tumour area compared to fatty breast). Sensitivity of US was inversely related to age (density-adjusted OR = 2.3, 95%, CI 1.0-5.2 in age group 26-49 compared to age group 60-92) and directly related with fattiness of breast (age-adjusted OR = 0.5, 95%, CI 0.2-0.9 by dense breast parenchyma in tumour area compared to fatty breast). Density in the tumour area compared to total breast density was related only mariginally better sensitivity both of mammography (0.4 vs. 0.6) and of US (0.5 vs. 0.6). CONCLUSION: Sensitivity of both mammography and sensitivity of US are independently related both to the age of the patient and to the density of the breast. The effect of age is inverse and that of density parallel between mammography and US on sensitivity. The effect of overall breast density was close to the effect of density at the site of the tumour on the sensitivity of both mammography and US.

Adult↗
PubMed2003

Mammography surveillance following breast cancer.

BACKGROUND: To describe when women diagnosed with breast cancer return for their first mammography, and to identify factors predictive of women returning for mammographic surveillance. METHODS: Women who underwent mammography at facilities participating in the National Cancer Institute's Breast Cancer Surveillance Consortium (BCSC) during 1996 and who were subsequently diagnosed with ductal carcinoma in situ or invasive breast cancer were included in this study. Data from seven mammography registries were linked to population-based cancer and pathology registries. Kaplan-Meier curves were used to depict the number of months from the breast cancer diagnosis to the first mammogram within the defined follow-up period. Demographic, disease and treatment variables were included in univariate and multivariate analyses to identify factors predictive of women returning for mammography. RESULTS: Of the 2503 women diagnosed with breast cancer, 78.1% returned for mammography examination between 7 and 30 months following the diagnosis. Mammography facilities indicated that 66.8% of mammography examinations were classified as screening. Multivariate analyses found that women were most likely to undergo surveillance mammography if they were diagnosed at ages 60-69 with Stage 0, I or II breast cancer and had received radiation therapy in addition to surgery. CONCLUSIONS: While the majority of women return for mammographic surveillance following breast cancer, some important subgroups of women at higher risk for recurrence are less likely to return. Research is needed to determine why some women are not undergoing mammography surveillance after a breast cancer diagnosis and whether surveillance increases the chance of detecting tumors with a good prognosis.

Adult↗