Journal article
Factors associated with adequacy of diagnostic workup after abnormal breast cancer screening results
The Journal of the American Board of Family Practice, Vol.13(2), pp.94-100
03/01/2000
DOI: 10.3122/15572625-13-2-94
PMID: 10764189
Abstract
BACKGROUNDWomen with certain characteristics, such as those residing in rural areas, are less likely screened for breast cancer. To enhance detection of early breast cancer, it is imperative that all women who have abnormal screening results receive appropriate diagnostic procedures. This study reports differences in receipt of diagnostic services following abnormal screening results. METHODSScreening and diagnostic data were collected as part of a breast and cervical cancer early detection program aimed at reaching women of lower socioeconomic status. Women with completed diagnostic information after having abnormal screening results were included. We based adequacy of diagnostic services on guidelines from the Society for Surgical Oncology, The Commission on Cancer of the American College of Surgeons, and the Centers for Disease Control and Prevention. Several factors were assessed for their association with adequacy of diagnostic follow-up: income, age, race, education, health insurance status, rural-urban residence, reported breast lump, family history of breast cancer, and clinical beast examination or mammogram results. RESULTSOverall, 14.1% of the 351 abnormal findings were considered inadequately followed up based on the algorithm used. Eighty percent involved an abnormal finding on a clinical breast examination regardless of the mammogram results. Rural women, those with abnormal clinical breast examination findings but normal or equivocal findings on mammograms, and those who self-discovered a mass were less likely to receive adequate follow-up than were their counterparts in multivariate analysis. Rural women were less likely to receive a biopsy or fine-needle aspiration, although it was indicated. One facility accounted for most of the inadequate follow-up screenings among urban women. CONCLUSIONSWomen who have specific demographic and clinical characteristics were less likely to have received adequate diagnostic services. Breast cancers could have been missed initially as a result of inappropriate follow-up. Further investigation of the clinical scenarios using chart reviews is warranted.
Details
- Title: Subtitle
- Factors associated with adequacy of diagnostic workup after abnormal breast cancer screening results
- Creators
- M Schootman - Jewish HospitalJ Myers-GeadelmannL Fuortes
- Resource Type
- Journal article
- Publication Details
- The Journal of the American Board of Family Practice, Vol.13(2), pp.94-100
- DOI
- 10.3122/15572625-13-2-94
- PMID
- 10764189
- ISSN
- 0893-8652
- eISSN
- 1544-8770
- Language
- English
- Date published
- 03/01/2000
- Academic Unit
- Occupational and Environmental Health; Internal Medicine
- Record Identifier
- 9984363594402771
Metrics
3 Record Views