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Adherence to long-term surveillance mammography among women with ductal carcinoma in situ treated with breast-conserving surgery.

Abstract
PURPOSE Breast-conserving surgery (BCS) is an effective treatment for ductal carcinoma in situ (DCIS) but women who undergo BCS remain at risk for recurrences. Whether mammographic surveillance after BCS occurs and by whom is not known. METHODS We reviewed medical records of women diagnosed with DCIS between 1990 and 2001 and treated with BCS. Using descriptive statistics, generalized estimating, and logistic regression modeling, we examined the rates and predictors of surveillance mammography over a 10-year period after BCS. Results The cohort included 3,037 women observed for a median of 4.8 years (range, 0.5 to 15.7). Of the 2,676 women observed for at least 1 year after BCS, most (79%) had at least one surveillance mammogram during the first year of follow-up; 69% in year 5 and 61% in year 10. Among those observed for 5 years, surveillance mammograms were more likely among women age 60 to 69 years (odds ratio [OR], 1.72; 95% CI, 1.26 to 2.34), users of menopausal hormone therapy at diagnosis (OR, 1.26; 95% CI, 1.01 to 1.57) as well as those treated with adjuvant radiation (OR, 1.28; 95% CI, 1.08 to 1.53) and adjuvant radiation with tamoxifen (OR, 1.61; 95% CI, 1.13 to 2.30). Surveillance mammograms were less likely among obese women (OR, 0.70; 95% CI, 0.56 to 0.86). The findings were similar among women observed for 10 years. Only 34% and 15% of women observed for 5 and 10 years, respectively, had a surveillance mammogram during each year of follow-up. CONCLUSION Surveillance mammography after BCS among insured women with DCIS often did not occur yearly and declined over time after treatment. Patients and providers must remain vigilant about surveillance after BCS.
AuthorsLarissa Nekhlyudov, Laurel A Habel, Ninah S Achacoso, Inkyung Jung, Reina Haque, Laura C Collins, Stuart J Schnitt, Charles P Quesenberry Jr, Suzanne W Fletcher
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 27 Issue 19 Pg. 3211-6 (Jul 01 2009) ISSN: 1527-7755 [Electronic] United States
PMID19433691 (Publication Type: Journal Article)
Topics
  • Aged
  • Breast Neoplasms (diagnostic imaging, surgery)
  • Carcinoma in Situ (diagnostic imaging, surgery)
  • Carcinoma, Ductal, Breast (diagnostic imaging, surgery)
  • Female
  • Humans
  • Mammography
  • Mastectomy, Segmental
  • Middle Aged
  • Patient Compliance (statistics & numerical data)

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