Nonadherence to Posttreatment Imaging Follow-up Common Among Breast Cancer Survivors

Nonadherence to Posttreatment Imaging Follow-up Common Among Breast Cancer Survivors
Nonadherence to Posttreatment Imaging Follow-up Common Among Breast Cancer Survivors

Nearly one-third of women with breast cancer are not undergoing recommended posttreatment surveillance imaging, according to a presentation at the 2016 Annual Clinical Congress of the American College of Surgeons.1,2

Previous studies suggest that annual surveillance mammography after breast cancer treatment is underutilized among Medicare recipients. Use of mammography among the broader population of breast cancer survivors and the role of magnetic resonance imaging (MRI) are unknown. Therefore, researchers sought to understand the factors associated with imaging use to determine how posttreatment guidelines adherence could be improved.

Using the National Cancer Data Base, researchers identified a random sample of 9622 women who underwent a surgical procedure to treat stage II and stage III breast cancer from 2006 through 2007. Half of the women were younger than 60 years. The researchers assessed for imaging, cancer recurrence, new cancer, and death. Additional data collected was on the reason for imaging (eg, evaluation of new signs or symptoms or surveillance imaging with no new signs and symptoms).

The study findings showed an 8% decline in surveillance breast imaging from posttreatment year 1 (66%) to year 4 (58%), and breast MRI was used in only approximately 10% of those who underwent surveillance imaging.

The researchers found younger age, black race, insurance status, worse health, more advanced cancers, excision alone or mastectomy vs lumpectomy with radiation, and lack of systemic therapy were associated with not undergoing breast imaging. In addition, the researchers found that use of mammography was not influenced by where women received their care, but use of MRI was.

The most significant finding, however, was that more than 30% of women do not undergo surveillance breast imaging.

“The bulk of the disparity seems to occur in that first year of follow-up, so it's really important to think about what we might be able to do in that timeframe to make sure women get guideline-recommended breast imaging,” said Jessica R Schumacher, PhD, an associate scientist at the Wisconsin Surgical Outcomes Research Program and a co-author of the study.2

References

1. Adesoye T, Schumacher JR, Neuman HB, et al. Utilization of surveillance breast imaging after treatment for locoregional breast cancer. J Am Coll Surg. 2016;233(4suppl1):S21.

2. American College of Surgeons. One-third of breast cancer patients not getting appropriate breast imaging follow-up exam. EurekAlert! web site. https://www.eurekalert.org/pub_releases/2016-10/acos-oob101916.php. October 19, 2016. Accessed October 25, 2016.

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