title: Ductal carcinoma in situ (DCIS): posttreatment follow-up care among Latina and non-Latina White women.
abstract: BACKGROUND
  There is a lack of information about posttreatment care among patients with ductal carcinoma in situ (DCIS). This study compares posttreatment care by ethnicity-language and physician specialty among Latina and White women with DCIS.
  
  
  METHODS
  Latina and White women diagnosed with DCIS between 2002 and 2005 identified through the California Cancer Registry completed a telephone survey in 2006. Main outcomes were breast surveillance, lifestyle counseling, and follow-up physician specialty.
  
  
  RESULTS
  Of 742 women (396 White, 349 Latinas), most (90 %) had at least one clinical breast exam (CBE). Among women treated with breast-conserving surgery (BCS; N = 503), 76 % had received at least two mammograms. While 92 % of all women had follow-up with a breast specialist, Spanish-speaking Latinas had the lowest specialist follow-up rates (84 %) of all groups. Lifestyle counseling was low with only 53 % discussing exercise, 43 % weight, and 31 % alcohol in relation to their DCIS. In multivariable analysis, Spanish-speaking Latinas with BCS had lower odds of receiving the recommended mammography screening in the year following treatment compared to Whites (OR 0.5; 95 % CI, 0.2-0.9). Regardless of ethnicity-language, seeing both a specialist and primary care physician increased the odds of mammography screening and CBE (OR 1.6; 95 % CI, 1.2-2.3 and OR 1.9; 95 % CI, 1.3-2.8), as well as having discussions about exercise, weight, and alcohol use, compared to seeing a specialist only.
  
  
  CONCLUSIONS
  Most women reported appropriate surveillance after DCIS treatment. However, our results suggest less adequate follow-up for Spanish-speaking Latinas, possibly due to language barriers or insurance access.
  
  
  CONCLUSIONS
  Follow-up with a primary care provider in addition to a breast specialist increases receipt of appropriate follow-up for all women.
authors: Division of General Internal Medicine, Department of Medicine, University of California San Francisco, 1545 Divisadero Street, San Francisco, CA 94143-0320, USA.
authors: Mónica E
authors: ME
authors: López
authors: Celia P
authors: CP
authors: Kaplan
authors: Anna M
authors: AM
authors: Nápoles
authors: Jennifer C
authors: JC
authors: Livaudais
authors: E Shelley
authors: ES
authors: Hwang
authors: Susan L
authors: SL
authors: Stewart
authors: Joan
authors: J
authors: Bloom
authors: Leah
authors: L
authors: Karliner
mesh_terms: D000359:Aftercare / Q000191:economics / Q000706:statistics & numerical data*; D000428:Alcohol Drinking / Q000453:epidemiology; D001943:Breast Neoplasms / Q000208:ethnology / Q000628:therapy*; D002140:California / Q000453:epidemiology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000208:ethnology / Q000628:therapy*; D003144:Communication Barriers; D015897:Comorbidity; D003376:Counseling / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007802:Language; D008019:Life Style; D008327:Mammography / Q000706:statistics & numerical data; D015412:Mastectomy, Segmental; D009819:Office Visits / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D017741:Survivors / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data*