title: Does a High-Risk Recommendation in Mammography Reports Increase Attendance at a Breast Cancer Risk Assessment Clinic?
abstract: OBJECTIVE
  This study evaluates the effectiveness of introducing, in 2012, a standardized recommendation into mammography reports, to recruit women at high risk for breast cancer into our risk assessment clinic.
  
  
  METHODS
  The study population was comprised of patients presenting for screening or diagnostic mammography, in 2011 and 2013, who were identified as having a ≥20% lifetime risk for breast cancer. Mammographic reports were assessed for annotations addressing the patients' risk status and referral to a provider at the clinic. The percentage of patients given a high-risk recommendation who did, versus did not, consult a provider at the clinic, within 1 year of their mammogram, was analyzed.
  
  
  RESULTS
  A total of 173 patients in 2011, and 241 patients in 2013, were identified as having a ≥20% lifetime risk of developing breast cancer. Of these, 40.5% were given a recommendation to attend our risk assessment clinic in 2011, versus 75.5% in 2013. Despite the overall increase in such recommendations by radiologists, only a modest increase occurred, from 11.4% to 14.3%, in patients that subsequently attended our risk assessment clinic.
  
  
  CONCLUSIONS
  Although the number of referrals to our high-risk clinic increased modestly after institution of a standardized reporting recommendation, >85% of patients at high risk, in 2013, did not consult a provider for patients at high risk, regarding their elevated lifetime risk of breast cancer.
authors.affiliation: Department of Radiology, Penn State Hershey Breast Center, and Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Ankur M
authors.initials: AM
authors.lastname: Vaidya
authors.affiliation: Department of Radiology, Penn State Hershey Breast Center, and Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania. Electronic address: achetlen@hmc.psu.edu.
authors.forename: Alison L
authors.initials: AL
authors.lastname: Chetlen
authors.affiliation: Department of Radiology, Penn State Hershey Breast Center, and Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Susann E
authors.initials: SE
authors.lastname: Schetter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012984:Software
keywords: Breast risk assessment clinic; breast cancer; high risk; mammography; standardized reporting