TY - JOUR
T1 - Adherence to guidelines for breast surveillance in breast cancer survivors
AU - Ruddy, Kathryn J.
AU - Sangaralingham, Lindsey
AU - Freedman, Rachel A.
AU - Mougalian, Sarah
AU - Neuman, Heather
AU - Greenberg, Caprice
AU - Jemal, Ahmedin
AU - Duma, Narjust
AU - Haddad, Tufia C.
AU - Lemaine, Valerie
AU - Ghosh, Karthik
AU - Hieken, Tina J.
AU - Hunt, Katie
AU - Vachon, Celine
AU - Gross, Cary
AU - Shah, Nilay D.
N1 - Funding Information:
had travel expenses associated with activities listed herein paid by Bonti, ACEL RX, and Lifecell. Dr. Vachon has disclosed that she has a leadership role with and has received research funding from Grail Inc. The remaining authors have disclosed that they have no financial interests, arrangements, affiliations, or commercial interests with the manufacturers of any products discussed in this article or their competitors. Dr. Ruddy and Ms. Sangaralingham were supported by an NCCN Young Investigator Award (PI: Ruddy). Author contributions: Study concept: Ruddy. Study design: Ruddy, Sangaralingham, Freedman, Mougalian, Neuman, Greenberg, Jemal, Gross, Shah. Funding acquisition: Ruddy. Data analysis: Sangaralingham. Interpretation of results: Ruddy, Freedman, Mougalian, Neuman, Greenberg, Jemal, Duma, Haddad, Lemaine, Ghosh, Hieken, Hunt, Vachon, Gross, Shah. Manuscript preparation: Ruddy. Critical revision and final approval: All authors. Correspondence: Kathryn J. Ruddy, MD, MPH, Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Email: Ruddy.kathryn@mayo.edu
Publisher Copyright:
© JNCCN-Journal of the National Comprehensive Cancer Network.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Background: Guidelines recommend annual mammography after curative-intent treatment for breast cancer. The goal of this study was to assess contemporary patterns of breast imaging after breast cancer treatment. Methods: Administrative claims data were used to identify privately insured and Medicare Advantage beneficiaries with nonmetastatic breast cancer who had residual breast tissue (not bilateral mastectomy) after breast surgery between January 2005 and May 2015. We calculated the proportion of patients who had a mammogram, MRI, both, or neither during each of 5 subsequent 13-month periods. Multinomial logistic regression was used to assess associations between patient characteristics, healthcare use, and breast imaging in the first and fifth years after surgery. Results: A total of 27,212 patients were followed for a median of 2.9 years (interquartile range, 1.8-4.6) after definitive breast cancer surgery. In year 1, 78% were screened using mammography alone, 1% using MRI alone, and 8% using both tests; 13% did not undergo either. By year 5, the proportion of the remaining cohort (n=4,790) who had no breast imaging was 19%. Older age was associated with an increased likelihood of mammography and a decreased likelihood of MRI during the first and fifth years. Black race, mastectomy, chemotherapy, and no MRI at baseline were all associated with a decreased likelihood of both types of imaging. Conclusions: Even in an insured cohort, a substantial proportion of breast cancer survivors do not undergo annual surveillance breast imaging, particularly as time passes. Understanding factors associated with imaging in cancer survivors may help improve adherence to survivorship care guidelines.
AB - Background: Guidelines recommend annual mammography after curative-intent treatment for breast cancer. The goal of this study was to assess contemporary patterns of breast imaging after breast cancer treatment. Methods: Administrative claims data were used to identify privately insured and Medicare Advantage beneficiaries with nonmetastatic breast cancer who had residual breast tissue (not bilateral mastectomy) after breast surgery between January 2005 and May 2015. We calculated the proportion of patients who had a mammogram, MRI, both, or neither during each of 5 subsequent 13-month periods. Multinomial logistic regression was used to assess associations between patient characteristics, healthcare use, and breast imaging in the first and fifth years after surgery. Results: A total of 27,212 patients were followed for a median of 2.9 years (interquartile range, 1.8-4.6) after definitive breast cancer surgery. In year 1, 78% were screened using mammography alone, 1% using MRI alone, and 8% using both tests; 13% did not undergo either. By year 5, the proportion of the remaining cohort (n=4,790) who had no breast imaging was 19%. Older age was associated with an increased likelihood of mammography and a decreased likelihood of MRI during the first and fifth years. Black race, mastectomy, chemotherapy, and no MRI at baseline were all associated with a decreased likelihood of both types of imaging. Conclusions: Even in an insured cohort, a substantial proportion of breast cancer survivors do not undergo annual surveillance breast imaging, particularly as time passes. Understanding factors associated with imaging in cancer survivors may help improve adherence to survivorship care guidelines.
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U2 - 10.6004/jnccn.2018.7001
DO - 10.6004/jnccn.2018.7001
M3 - Article
C2 - 29752327
AN - SCOPUS:85046901000
SN - 1540-1405
VL - 16
SP - 526
EP - 534
JO - JNCCN Journal of the National Comprehensive Cancer Network
JF - JNCCN Journal of the National Comprehensive Cancer Network
IS - 5
ER -