title: Time to Diagnostic Evaluation After Mammographic Screening in an Urban Setting.
abstract: The Capital Breast Care Center (CBCC), a screening facility established to serve minority women, developed a culturally sensitive patient care paradigm that would address concerns of adherence to follow-up of abnormal results after initial mammogram. Women with abnormal mammograms are assigned a Black or Latina navigator who facilitates the additional workup needed by scheduling follow-up, arranging transportation, providing counsel/emotional support, and even accompanying them to diagnostic imaging or biopsy appointment. We present data on follow-up rates after breast cancer screening.
  
  
  
  All patients seen at CBCC are entered into a prospectively collected database. We calculated intervals (in days) between the screening and diagnostic visits. Descriptive statistics and median time to follow-up are reported. Differences between Black and Hispanic women on time interval were tested by t-test.
  
  
  
  From January 2010 to December 2012, 4605 digital screening mammograms were performed. Fifty-two percent of the women self-identified as Black, 41% as Hispanic, 4% White, 2% Asian, and 1% as "other." Of the screening studies, 451 (9.8%) required additional workup, out of which 362 (80%) of the women returned for the recommended diagnostic imaging. The median interval between screening and diagnostic imaging was 39 days (range: 6-400). Of the 162 women recommended to have a core needle biopsy, 81.5% underwent biopsy within a median of 21 days (range: 0-221 days).
  
  
  
  At the CBCC, time to patient follow-up after initial mammographic screening is within the CDC-recommended performance standard of less than 60 days. For a population that historically has low rates of clinical follow-up, we attribute this reduction in delays to breast cancer diagnostic resolution to a culturally sensitive patient navigation program. Additional studies are needed to assess how the existing navigation program can be individualized/tailored to target the remaining 20% of women who did not adhere to the recommended workup.
authors.affiliation: 1 Breast Division, Department of Surgery, MedStar Georgetown University Hospital , Washington, District of Columbia.|2 Georgetown University Lombardi Comprehensive Cancer Center , Washington, District of Columbia.
authors.forename: Bridget A
authors.initials: BA
authors.lastname: Oppong
authors.affiliation: 2 Georgetown University Lombardi Comprehensive Cancer Center , Washington, District of Columbia.
authors.forename: Chiranjeev
authors.initials: C
authors.lastname: Dash
authors.affiliation: 3 Capital Breast Care Center, Georgetown Lombardi Comprehensive Cancer Center , Washington, District of Columbia.
authors.forename: Tesha
authors.initials: T
authors.lastname: Coleman
authors.affiliation: 3 Capital Breast Care Center, Georgetown Lombardi Comprehensive Cancer Center , Washington, District of Columbia.
authors.forename: Tanya
authors.initials: T
authors.lastname: Torres
authors.affiliation: 2 Georgetown University Lombardi Comprehensive Cancer Center , Washington, District of Columbia.
authors.forename: Lucile L
authors.initials: LL
authors.lastname: Adams-Campbell
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D003266:Continuity of Patient Care; D003695:Delivery of Health Care / Q000458:organization & administration*; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D054525:Minority Health; D010349:Patient Compliance; D062526:Patient Navigation; D018802:Patient-Centered Care; D011446:Prospective Studies; D012959:Socioeconomic Factors; D013997:Time Factors; D061665:Time-to-Treatment; D014505:Urban Population / Q000706:statistics & numerical data
keywords: breast cancer; diagnostic; minority health; patient navigation; screening mammography