title: Timeliness of follow-up after abnormal screening mammogram: variability of facilities.
abstract: OBJECTIVE
  To describe the timeliness of follow-up care in community-based settings among women who receive a recommendation for immediate follow-up during the screening mammography process and how follow-up timeliness varies according to facility and facility-level characteristics.
  
  
  METHODS
  This was an institutional review board-approved and HIPAA-compliant study. Screening mammograms obtained from 1996 to 2007 in women 40-80 years old in the Breast Cancer Surveillance Consortium were examined. Inclusion criteria were a recommendation for immediate follow-up at screening, or subsequent imaging, and observed follow-up within 180 days of the recommendation. Recommendations for additional imaging (AI) and biopsy or surgical consultation (BSC) were analyzed separately. The distribution of time to follow-up care was estimated by using the Kaplan-Meier estimator.
  
  
  RESULTS
  Data were available on 214,897 AI recommendations from 118 facilities and 35,622 BSC recommendations from 101 facilities. The median time to subsequent follow-up care after recommendation was 14 days for AI and 16 days for BSC. Approximately 90% of AI follow-up and 81% of BSC follow-up occurred within 30 days. Facilities with higher recall rates tended to have longer AI follow-up times (P < .001). Over the study period, BSC follow-up rates at 15 and 30 days improved (P < .001). Follow-up times varied substantially across facilities. Timely follow-up was associated with larger volumes of the recommended procedures but not notably associated with facility type nor observed facility-level characteristics.
  
  
  CONCLUSIONS
  Most patients with follow-up returned within 3 weeks of the recommendation.
authors: Department of Radiology, University of New Mexico-HSC, 1 University of New Mexico, HSC 10 5530, Albuquerque, NM 87131-0001, USA. rrosenb@unm.edu
authors: Robert D
authors: RD
authors: Rosenberg
authors: Sebastien J P A
authors: SJ
authors: Haneuse
authors: Berta M
authors: BM
authors: Geller
authors: Diana S M
authors: DS
authors: Buist
authors: Diana L
authors: DL
authors: Miglioretti
authors: R James
authors: RJ
authors: Brenner
authors: Rebecca
authors: R
authors: Smith-Bindman
authors: Stephen H
authors: SH
authors: Taplin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D010349:Patient Compliance; D012042:Registries; D013997:Time Factors; D014481:United States / Q000453:epidemiology