Predicting reattendance at a high-risk breast cancer clinic.
OBJECTIVE
The research about follow-up patterns of women attending high-risk breast-cancer clinics is sparse. This study sought to profile daughters of breast-cancer patients who are likely to return versus those unlikely to return for follow-up care in a high-risk clinic.


METHODS
Our investigation included 131 patients attending the UCLA Revlon Breast Center High Risk Clinic. Predictor variables included age, computed breast-cancer risk, participants' perceived personal risk, clinically significant depressive symptomatology (CES-D score ≥ 16), current level of anxiety (State-Trait Anxiety Inventory), and survival status of participants' mothers (survived or passed away from breast cancer).


RESULTS
A greater likelihood of reattendance was associated with older age (adjusted odds ratio [AOR] = 1.07, p = 0.004), computed breast-cancer risk (AOR = 1.10, p = 0.017), absence of depressive symptomatology (AOR = 0.25, p = 0.009), past psychiatric diagnosis (AOR = 3.14, p = 0.029), and maternal loss to breast cancer (AOR = 2.59, p = 0.034). Also, an interaction was found between mother's survival and perceived risk (p = 0.019), such that reattendance was associated with higher perceived risk among participants whose mothers survived (AOR = 1.04, p = 0.002), but not those whose mothers died (AOR = 0.99, p = 0.685). Furthermore, a nonlinear inverted "U" relationship was observed between state anxiety and reattendance (p = 0.037); participants with moderate anxiety were more likely to reattend than those with low or high anxiety levels.


CONCLUSIONS
Demographic, medical, and psychosocial factors were found to be independently associated with reattendance to a high-risk breast-cancer clinic. Explication of the profiles of women who may or may not reattend may serve to inform the development and implementation of interventions to increase the likelihood of follow-up care.
Department of Psychiatry and Biobehavioral Sciences,David Geffen School of Medicine at UCLA,Los Angeles,California.
Sarah R
http://orcid.org/0000-0002-0565-5255
SR
Ormseth
Department of Psychiatry and Biobehavioral Sciences,David Geffen School of Medicine at UCLA,Los Angeles,California.
David K
DK
Wellisch
Department of Psychology,Loma Linda University,Loma Linda,California.
Adam E
AE
Aréchiga
Department of Psychology,Loma Linda University,Loma Linda,California.
Taylor L
TL
Draper
D000328:Adult; D032721:Adult Children / Q000523:psychology; D017677:Age Distribution; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control / Q000523:psychology*; D055088:Early Detection of Cancer / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D005544:Forecasting; D020022:Genetic Predisposition to Disease / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D015141:Los Angeles; D008603:Mental Health; D009034:Mother-Child Relations / Q000523:psychology; D009035:Mothers; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D018570:Risk Assessment
Breast neoplasms; Early detection of cancer; Genetic predisposition to disease; Mother–child relationship; Patient compliance