Are risk factors for breast cancer associated with follow-up procedures in diverse women with abnormal mammography?
OBJECTIVE
We evaluated the association of risk factors for breast cancer with reported follow-up procedures after abnormal mammography among diverse women.


METHODS
Women ages 40--80 years were recruited from four clinical sites after receiving a screening mammography result that was classified as abnormal but probably benign, suspicious or highly suspicious, or indeterminate using standard criteria. A telephone-administered survey asked about breast cancer risk factors (family history, estrogen use, physical inactivity, age of menarche, age at birth of first child, parity, alcohol use), and self-reported use of diagnostic tests (follow-up mammogram, breast ultrasound, or biopsy).


RESULTS
Nine hundred and seventy women completed the interview, mean age was 56, 42% were White, 19% Latina, 25% African American, and 15% Asian. White women were more likely to have a positive family history (20%), use estrogen (32%), be nulliparous (17%) and drink alcohol (62%). Latinas were more likely to be physically inactive (93%), African Americans to have early onset of menarche (53%) and Asians first child after age 30 (21%). White women were more likely to have suspicious mammograms (40%) and to undergo biopsy (45%). In multivariate models, Latinas were more likely to report breast ultrasound, physical inactive women reported fewer follow-up mammograms, and care outside the academic health center was associated with fewer biopsies. Indeterminate and suspicious mammography interpretations were significantly associated with more biopsy procedures (OR=8.4; 95% CI=3.8-18.5 and OR=59; 95% CI=35-100, respectively).


CONCLUSIONS
Demographic profile and breast cancer risk factors have little effect on self-reported use of diagnostic procedures following an abnormal mammography examination. Level of mammography abnormality determines diagnostic evaluation but variance by site of care was observed.
Juarbe
Teresa C
TC
Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco (UCSF), USA.
Kaplan
Celia Patricia
CP
Somkin
Carol P
CP
Pasick
Rena
R
Gildengorin
Ginny
G
Pérez-Stable
Eliseo J
EJ
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology*; D003710:Demography; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010298:Parity; D010375:Pedigree; D012307:Risk Factors