Obesity, gynecological factors, and abnormal mammography follow-up in minority and medically underserved women.
BACKGROUND
The relationship between obesity and screening mammography adherence has been examined previously, yet few studies have investigated obesity as a potential mediator of timely follow-up of abnormal (Breast Imaging Reporting and Data System [BIRADS-0]) mammography results in minority and medically underserved patients.


METHODS
We conducted a retrospective cohort study of 35 women who did not return for follow-up >6 months from index abnormal mammography and 41 who returned for follow-up < or =6 months in Nashville, Tennessee. Patients with a BIRADS-0 mammography event in 2003-2004 were identified by chart review. Breast cancer risk factors were collected by telephone interview. Multivariate logistic regression was performed on selected factors with return for diagnostic follow-up.


RESULTS
Obesity and gynecological history were significant predictors of abnormal mammography resolution. A significantly higher frequency of obese women delayed return for mammography resolution compared with nonobese women (64.7% vs. 35.3%). A greater number of hysterectomized women returned for diagnostic follow-up compared with their counterparts without a hysterectomy (77.8% vs. 22.2%). Obese patients were more likely to delay follow-up >6 months (adjusted OR 4.09, p = 0.02). Conversely, hysterectomized women were significantly more likely to return for timely mammography follow-up < or =6 months (adjusted OR 7.95, p = 0.007).


CONCLUSIONS
Study results suggest that weight status and gynecological history influence patients' decisions to participate in mammography follow-up studies. Strategies are necessary to reduce weight-related barriers to mammography follow-up in the healthcare system including provider training related to mammography screening of obese women.
Fair
Alecia Malin
AM
Department of Surgery, Meharry Medical College, Nashville, Tennessee 37208, USA. afair@mmc.edu
Wujcik
Debra
D
Lin
Jin-Mann S
JM
Grau
Ana
A
Wilson
Veronica
V
Champion
Victoria
V
Zheng
Wei
W
Egan
Kathleen M
KM
D001943:Breast Neoplasms / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data*; D008507:Medically Underserved Area; D008913:Minority Groups; D009765:Obesity / Q000150:complications; D010349:Patient Compliance / Q000208:ethnology; D012189:Retrospective Studies; D016387:Women's Health