Patterns and predictors of mammography utilization among breast cancer survivors

Authors

  • Chyke A. Doubeni M.D., M.P.H.,

    Corresponding author
    1. Department of Family Medicine and Community Health, University of Massachusetts, Worcester, Massachusetts
    2. Meyers Primary Care Institute, University of Massachusetts Medical School, Fallon Foundation, and Fallon Community Health Plan, Worcester, Massachusetts
    • Department of Family Medicine and Community Health, University of Massachusetts Medical Center, 55 North Lake Ave., Worcester, MA 01655===

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    • Fax: (508) 856-1212

  • Terry S. Field D.Sc.,

    1. Meyers Primary Care Institute, University of Massachusetts Medical School, Fallon Foundation, and Fallon Community Health Plan, Worcester, Massachusetts
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  • Marianne Ulcickas Yood D.Sc., M.P.H.,

    1. Josephine Ford Cancer Center, Henry Ford Health System, Detroit, Michigan
    2. Department of Epidemiology and Public Health, Yale University School of Health, New Haven, Connecticut
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  • Sharon J. Rolnick Ph.D.,

    1. HealthPartners Research Foundation, Minneapolis, Minnesota
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  • Charles P. Quessenberry Ph.D.,

    1. Division of Research, Kaiser Permanente Northern California, Oakland, California
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  • Hassan Fouayzi M.S.,

    1. Meyers Primary Care Institute, University of Massachusetts Medical School, Fallon Foundation, and Fallon Community Health Plan, Worcester, Massachusetts
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  • Jerry H. Gurwitz M.D.,

    1. Meyers Primary Care Institute, University of Massachusetts Medical School, Fallon Foundation, and Fallon Community Health Plan, Worcester, Massachusetts
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  • Feifei Wei Ph.D.

    1. HealthPartners Research Foundation, Minneapolis, Minnesota
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Abstract

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 ≥ 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. Cancer 2006. © 2006 American Cancer Society.

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