Louise M Henderson1, Laura Ichikawa2, Diana S M Buist2, Janie M Lee3, Mary Bush2, Dianne Johnson2, Tracy Onega4, Larissa Nekhlyudov5, Karla Kerlikowske6,7, Diana L Miglioretti2,8, Brian L Sprague9, Karen J Wernli2. 1. Department of Radiology, The University of North Carolina Chapel Hill NC, Chapel Hill, NC, 27599-7515, USA. Louise_Henderson@med.unc.edu. 2. Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA. 3. Department of Radiology, Seattle Cancer Care Alliance, University of Washington, Seattle, WA, USA. 4. Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA. 5. Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. 6. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA. 7. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA. 8. Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA. 9. Department of Surgery, University of Vermont College of Medicine, Burlington, VT, USA.
Abstract
BACKGROUND: National patterns of breast imaging in women with a personal history of breast cancer (PHBC) are unknown making evaluation of annual surveillance recommendations a challenge. OBJECTIVE: To describe variation in use of mammography and breast magnetic resonance imaging (MRI) examinations beginning 6 months after diagnosis among women with PHBC in US community practice. We report on the breast imaging indication, imaging intervals, and time since breast cancer diagnosis by examination type. DESIGN: Longitudinal study using cross-sectional data. SETTING: Breast Cancer Surveillance Consortium breast imaging facilities. PARTICIPANTS: 19,955 women diagnosed between 2005 and 2012 with AJCC stage 0-III incident breast cancer who had 69,386 mammograms and 3,553 breast MRI examinations from January 2005 to September 2013; median follow-up of 37.6 months (interquartile range, 22.1-60.7). MAIN MEASURES: Breast imaging indication, imaging intervals, and time since breast cancer diagnosis by examination type. KEY RESULTS: Among women with a PHBC who received breast imaging, 89.4% underwent mammography alone, 0.8% MRI alone, and 10.3% had both mammography and MRI. About half of mammograms and MRIs were indicated for surveillance vs. diagnostic, with an increase in the proportion of surveillance exams as time from diagnosis increased (mammograms, 45.7% at 1 year to 72.2% after 5 years; MRIs, 54.8% at 1 year to 78.6% after 5 years). In the first post-diagnosis period, 32.8% of women had > 2 breast imaging examinations and of these, 65.8% were less than 6 months apart. During the first 5-year post-diagnosis, the frequency of examinations per year decreased and the interval between examinations shifted towards annual examinations. CONCLUSION: In women with a PHBC who received post-diagnosis imaging, a third underwent multiple breast imaging examinations per year during the first 2-year post-diagnosis despite recommendations for annual exams. As time since diagnosis increases, imaging indication shifts from diagnostic to surveillance.
BACKGROUND: National patterns of breast imaging in women with a personal history of breast cancer (PHBC) are unknown making evaluation of annual surveillance recommendations a challenge. OBJECTIVE: To describe variation in use of mammography and breast magnetic resonance imaging (MRI) examinations beginning 6 months after diagnosis among women with PHBC in US community practice. We report on the breast imaging indication, imaging intervals, and time since breast cancer diagnosis by examination type. DESIGN: Longitudinal study using cross-sectional data. SETTING:Breast Cancer Surveillance Consortium breast imaging facilities. PARTICIPANTS: 19,955 women diagnosed between 2005 and 2012 with AJCC stage 0-III incident breast cancer who had 69,386 mammograms and 3,553 breast MRI examinations from January 2005 to September 2013; median follow-up of 37.6 months (interquartile range, 22.1-60.7). MAIN MEASURES: Breast imaging indication, imaging intervals, and time since breast cancer diagnosis by examination type. KEY RESULTS: Among women with a PHBC who received breast imaging, 89.4% underwent mammography alone, 0.8% MRI alone, and 10.3% had both mammography and MRI. About half of mammograms and MRIs were indicated for surveillance vs. diagnostic, with an increase in the proportion of surveillance exams as time from diagnosis increased (mammograms, 45.7% at 1 year to 72.2% after 5 years; MRIs, 54.8% at 1 year to 78.6% after 5 years). In the first post-diagnosis period, 32.8% of women had > 2 breast imaging examinations and of these, 65.8% were less than 6 months apart. During the first 5-year post-diagnosis, the frequency of examinations per year decreased and the interval between examinations shifted towards annual examinations. CONCLUSION: In women with a PHBC who received post-diagnosis imaging, a third underwent multiple breast imaging examinations per year during the first 2-year post-diagnosis despite recommendations for annual exams. As time since diagnosis increases, imaging indication shifts from diagnostic to surveillance.
Entities:
Keywords:
breast cancer; breast magnetic resonance imaging; cancer surveillance; cancer survivorship; mammography
Authors: Diana S M Buist; Laura Ichikawa; Karen J Wernli; Christoph I Lee; Louise M Henderson; Karla Kerlikowske; Erin J A Bowles; Diana L Miglioretti; Jennifer Specht; Garth H Rauscher; Brian L Sprague; Tracy Onega; Janie M Lee Journal: J Am Coll Radiol Date: 2020-01-28 Impact factor: 5.532