title: Evaluating post-treatment screening in women with breast cancer.
abstract: OBJECTIVE
  The objective of this study was to evaluate the 5-year post-treatment use rate for screening mammography and clinical breast examination (CBE) among women treated for atypical hyperplasia (AH) or carcinoma in situ (CIS).
  
  
  METHODS
  A total of 103 women, who had received diagnoses and had been treated for primary AH or CIS, were observed for 5 years through a review of medical records and electronic databases. Adequate screening use was defined as the patient undergoing one mammography examination and at least one CBE per year.
  
  
  RESULTS
  Multivariate logistic regression showed that screening activity declined significantly with time. During the first year, 83.5% and 80.6%, respectively, of women were screened by CBE and mammography. By year 2, CBE screening had dropped by 25.2% (P <.01) and mammography screening by 9.7% (P =.08). Attrition in CBE and mammography screening continued for each consecutive year and was significant (P <.01). During the first year, 70.9% of women received both methods of screening, which declined to 9.7% by year 5. Women who had received diagnoses of CIS and those married with children were more likely to use post-treatment screening, while fee-for-service insurance was negatively associated with screening.
  
  
  CONCLUSIONS
  The reasons for the observed decline in the annual post-treatment screening are not known. Negative findings from follow-up screenings might have lowered the perception of cancer susceptibility and promoted the decline in screening use. A communication gap between physicians and patients might have reinforced this perception. The importance of annual screening may be verbally emphasized at each clinic visit, and reminder notes and telephone calls may be used to remind patients of upcoming screenings. Additional studies are planned to evaluate the effect of various intervention strategies in improving post-treatment screening use.
authors.affiliation: Division of Cancer Epidemiology and Prevention, Josephine Ford Cancer Center, Henry Ford Health System, Detroit, Michigan 48202, USA.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Stark
authors.forename: Angela
authors.initials: A
authors.lastname: Prince
authors.forename: Gena
authors.initials: G
authors.lastname: Kucera
authors.forename: Mei
authors.initials: M
authors.lastname: Lu
authors.forename: Usha
authors.initials: U
authors.lastname: Raju
authors.forename: David
authors.initials: D
authors.lastname: Nathanson
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening; D008875:Middle Aged; D010349:Patient Compliance; D012044:Regression Analysis; D013997:Time Factors