Article

Prediction of Incomplete Screening Mammograms Based on Age and Race

the Department of Obstetrics, Gynecology and Women's Health
The Journal of the American Board of Family Medicine (Impact Factor: 1.98). 01/2012; 25(1):128-30. DOI: 10.3122/jabfm.2012.01.110107
Source: PubMed

ABSTRACT

This study examined the age-associated rate of incomplete mammograms requiring additional testing based on Breast Imaging-Reporting and Data System (BIRADS) score.
A retrospective, observational study design from a tertiary medical center was used to evaluate which explanatory variables significantly predicted whether a woman had an incomplete mammogram. An incomplete mammogram was defined as a BIRADS score of 0 (requiring further imaging), whereas a benign process was defined as a BIRADS score of 1 or 2. Explanatory variables included traditional clinical factors (age, race, and menopausal state).
During the study period, 20,269 subjects were evaluated. The majority of the patients were white (n = 12,955; 64.6%) and had a BIRADS score consistent with a benign finding (n = 17,571; 86.6%). Premenopausal state (odds ratio [OR], 1.38; 95% CI, 1.27-1.50), white race (OR, 1.18; 95% CI, 1.08-1.29), and younger age (OR, 1.38; 95% CI, 1.27-1.50) significantly increased the odds a woman had an incomplete study.
In this cross-sectional, single-institution analysis, premenopausal state and white race are associated with an increased rate for incomplete mammograms. Patients should be counseled appropriately before the initiation of screening.

Full-text preview

Available from: jabfm.org
  • Source
    • "Women without a recent mammogram, White women, and those without a primary care physician were more likely to have a BIRAD 0 (incomplete) mammogram requiring follow up. The reasons for these associations were not evaluated by this study; however previous reports indicate an association of race and prediction of incomplete screening mammography [18]. In addition, in as much as past films are reviewed to aid in the disposition of mammography findings- views beyond initial screening may be required in those women for whom no prior screening history exists or is available- this may explain the association of screening recency and BIRAD 0 results in this study. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Mobile health units are increasingly utilized to address barriers to mammography screening. Despite the existence of mobile mammography outreach throughout the US, there is a paucity of data describing the populations served by mobile units and the ability of these programs to reach underserved populations, address disparities, and report on outcomes of screening performance. To evaluate the association of variables associated with outcomes for women undergoing breast cancer screening and clinical evaluation on a mobile unit. Retrospective analysis of women undergoing mammography screening during the period 2008-2010. Logistic regression was fitted using generalized estimating equations to account for potential repeat annual visits to the mobile unit. In total, 4,543 mammograms and/or clinical breast exams were conducted on 3,923 women with a mean age of 54.6, 29 % of whom had either never been screened or had not had a screening in 5 years. Age < 50 years, lack of insurance, Hispanic ethnicity, current smoking, or having a family relative (<50 years of age) with a diagnosis of cancer were associated with increased odds of a suspicious mammogram finding (BIRADS 4,5,6). Thirty-one breast cancers were detected. The mobile outreach initiative successfully engaged many women who had not had a recent mammogram. Lack of insurance and current smoking were modifiable variables associated with abnormal screens requiring follow up.
    Full-text · Article · May 2013 · Journal of Community Health
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Again, we present a rich issue with great information to address common clinical questions. A common class of drug (proton pump inhibitors) and insufficiently common diet (high fiber content) are related to improved diabetes control. Four good health habits make a huge difference, especially for obese patients. Meaningful use is just not always that meaningful. Computed tomography scans for common chest complaints probably are overused in emergency rooms. Continuous insurance is important to receipt of prevention services, even for those with access to care when they do not have insurance. Practice-based research can be difficult to accomplish, yet can yield some good results--in this case, improved colon cancer screening rates. Consider hyperaldosteronism in patients with resistant hypertension. Reflect on the mistakes other family physicians report; we often learn from others' mistakes. Surgical mesh migration can cause many things, but would you guess it would cause symptoms of irritable bowel syndrome? A nice primer on what is known about chemoprevention of prostate cancer. And, how to influence care outcomes: high-leverage, not just measurable, activities.
    Full-text · Article · Jan 2012 · The Journal of the American Board of Family Medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: The literature on breast cancer inevitably includes age as a risk factor for the disease, and there is considerable controversy regarding the best age for women to start screening mammography. A woman's breast develops and changes over the course of her lifetime, and at various times is more or less susceptible to cancer. Developmental differences also affect breast imaging. This article focuses on the age groups outside the majority of women who receive breast cancer diagnoses, instead emphasizing effects of age on the very youngest and oldest women.
    No preview · Article · Sep 2012 · Radiologic technology