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Patterns of Breast Imaging Use Among Women with a Personal History of Breast Cancer

  • Louise M. HendersonEmail author
  • Laura Ichikawa
  • Diana S. M. Buist
  • Janie M. Lee
  • Mary Bush
  • Dianne Johnson
  • Tracy Onega
  • Larissa Nekhlyudov
  • Karla Kerlikowske
  • Diana L. Miglioretti
  • Brian L. Sprague
  • Karen J. Wernli
Article

Abstract

Background

National patterns of breast imaging in women with a personal history of breast cancer (PHBC) are unknown making evaluation of annual surveillance recommendations a challenge.

Objective

To describe variation in use of mammography and breast magnetic resonance imaging (MRI) examinations beginning 6 months after diagnosis among women with PHBC in US community practice. We report on the breast imaging indication, imaging intervals, and time since breast cancer diagnosis by examination type.

Design

Longitudinal study using cross-sectional data.

Setting

Breast Cancer Surveillance Consortium breast imaging facilities.

Participants

19,955 women diagnosed between 2005 and 2012 with AJCC stage 0-III incident breast cancer who had 69,386 mammograms and 3,553 breast MRI examinations from January 2005 to September 2013; median follow-up of 37.6 months (interquartile range, 22.1–60.7).

Main Measures

Breast imaging indication, imaging intervals, and time since breast cancer diagnosis by examination type.

Key Results

Among women with a PHBC who received breast imaging, 89.4% underwent mammography alone, 0.8% MRI alone, and 10.3% had both mammography and MRI. About half of mammograms and MRIs were indicated for surveillance vs. diagnostic, with an increase in the proportion of surveillance exams as time from diagnosis increased (mammograms, 45.7% at 1 year to 72.2% after 5 years; MRIs, 54.8% at 1 year to 78.6% after 5 years). In the first post-diagnosis period, 32.8% of women had > 2 breast imaging examinations and of these, 65.8% were less than 6 months apart. During the first 5-year post-diagnosis, the frequency of examinations per year decreased and the interval between examinations shifted towards annual examinations.

Conclusion

In women with a PHBC who received post-diagnosis imaging, a third underwent multiple breast imaging examinations per year during the first 2-year post-diagnosis despite recommendations for annual exams. As time since diagnosis increases, imaging indication shifts from diagnostic to surveillance.

KEY WORDS

breast cancer cancer surveillance mammography breast magnetic resonance imaging cancer survivorship 

Notes

Acknowledgments

We thank the participating women, mammography facilities, and radiologists for the data they have provided for this study. Further, we thank the study Patient Advisory Board and Stakeholder Panel for their ongoing support of this research project.

Authors’ Contribution

The collection of cancer and vital status data used in this study was supported in part by several state public health departments and cancer registries throughout the US. For a full description of the BCSC, please see: http://www.bcsc-research.org/.

Funding

This study was funded by the Patient-Centered Outcomes Research Institute (PCORI) (grant number CE-1304-6656 “Comparative effectiveness of surveillance imaging modalities in breast cancer survivors”) and the National Cancer Institute (grant numbers: P01 CA154292, U54 CA163303).

Compliance with Ethical Standards

Conflict of Interest

Author Diana L. Miglioretti was a member of the Scientific Advisory Board for Hologic in 2017. Author Janie M. Lee is a consultant for General Electric Healthcare and receives a Research Grant from General Electric Healthcare. All remaining authors declare that they do not have a conflict of interest.

Disclaimer

The design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication are solely the responsibility of the authors and does not necessarily represent the official views of the Patient-Centered Outcomes Research Institute, the National Cancer Institute or the National Institutes of Health.

Supplementary material

11606_2019_5181_MOESM1_ESM.docx (25 kb)
ESM 1 (DOCX 25 kb)

References

  1. 1.
    Miller KD, Siegel RL, Lin CC, et al. Cancer Treatment and Survivorship Statistics, 2016. CA Cancer J Clin 2016;66:271–289.CrossRefGoogle Scholar
  2. 2.
    Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, Cannady RS, Pratt-Chapman ML, Edge SB, Jacobs LA, Hurria A, Marks LB, LaMonte SJ, Warner E, Lyman GH, Ganz PA. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. J Clin Oncol. 2016;34(6):611–35.CrossRefGoogle Scholar
  3. 3.
    Khatcheressian JL, Hurley P, Bantug E, Esserman LJ, Grunfeld E, Halberg F, Hantel A, Henry NL, Muss HB, Smith TJ, Vogel VG, Wolff AC, Somerfield MR, Davidson NE, American Society of Clinical Oncology. Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:961–5.CrossRefGoogle Scholar
  4. 4.
    National Comprehensive Cancer Network (NCCN). Clinical Practice Guidelines in Oncology - Breast Cancer. Fort Washington, PA: National Comprehensive Cancer Network (NCCN); 2016 [cited 2016 January 6]; Clinical Practice Guidelines in Oncology - Breast Cancer, Version 1.2016. Available from: http://nccn.org. Accessed 05/07/2019.
  5. 5.
    Lee CH, Dershaw DD, Kopans D, Evans P, Monsees B, Monticciolo D, Brenner RJ, Bassett L, Berg W, Feig S, Hendrick E, Mendelson E, D'Orsi C, Sickles E, Burhenne LW. Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer. J Am Coll Radiol. 2010;7(1):18–27.CrossRefGoogle Scholar
  6. 6.
    Houssami N, Abraham LA, Miglioretti DL, Sickles EA, Kerlikowske K, Buist DS, Geller BM, Muss HB, Irwig L. Accuracy and outcomes of screening mammography in women with a personal history of early-stage breast cancer. JAMA. 2011;305:790–9.CrossRefGoogle Scholar
  7. 7.
    Buist DS, Abraham LA, Barlow WE, et al. Diagnosis of second breast cancer events after initial diagnosis of early stage breast cancer. Breast Cancer Res Treat. 2010;124(3):863–873.CrossRefGoogle Scholar
  8. 8.
    Arasu VA, Joe BN, Lvoff NM et al. Benefit of Semiannual Ipsilateral Mammographic Surveillance Following Breast Conservation Therapy. Radiology. 2012;264(2):371–377.CrossRefGoogle Scholar
  9. 9.
    Keating NL, Landrum MB, Guadagnoli E, Winer EP, Ayanian JZ. Factors Related to Underuse of Surveillance Mammography Among Breast Cancer Survivors. J Clin Oncol. 2006;24(1):85–94.CrossRefGoogle Scholar
  10. 10.
    Enewold L, McGlynn KA, Zahm SH, et al. Surveillance mammography among female DOD beneficiairies: as study by race and ethnicity. Cancer. 2013; 119(19): 3531–3538.CrossRefGoogle Scholar
  11. 11.
    Onega T, Weiss J, diFlorio R, MacKenzie T, Goodrich M, Poplack S. Evaluating Surveillance Breast Imaging and Biopsy in Older Breast Cancer Survivors. Int J Breast Cancer. 2012; 2012:347646.CrossRefGoogle Scholar
  12. 12.
    Wirtz HS, Boudreau DM, Gralow JR et al. Factors associated with long-term adherence to annual surveillance mammography among breast cancer survivors. Breast Cancer Res Treat. 2014;143(3):541–50.CrossRefGoogle Scholar
  13. 13.
    Ruddy KJ, Sangaralingham L, Freedman RA, et al. Adherence to Guidelines for Breast Surveillance in Breast Cancer Survivors. J Natl Compr Canc Netw. 2018;16(5):526–534.CrossRefGoogle Scholar
  14. 14.
    Nekhlyudov L, Habel LA, Achacoso NS, et al. Adherence to Long-Term Surveillance Mammography Among Women with Ductal Carcinoma In Situ Treated with Breast-Conserving Surgery. J Clin Oncol. 2009;27(19):3211–3216.CrossRefGoogle Scholar
  15. 15.
    Nekhlyudov L, Habel LA, Achacoso N, et al. Ten-Year Risk of Diagnostic Mammograms and Invasive Breast Procedures After Breast-Conserving Surgery for DCIS. J Natl Cancer Inst. 2012;104:614–621.CrossRefGoogle Scholar
  16. 16.
    Wernli KJ, DeMartini WB, Ichikawa L, et al. Patterns of Breast Magnetic Resonance Imaging Use in Community Practice. JAMA Intern Med. 2014;174(1):125–132.CrossRefGoogle Scholar
  17. 17.
    Stout NK, Nekhlyudov L, Li L, et al. Rapid Rise of Breast Magnetic Resonance Imaging Use: Trends from 2000-2011. JAMA Intern Med. 2014; 174(1):114–121.CrossRefGoogle Scholar
  18. 18.
    Brandzel S, Rosenberg DE, Johnson D, et al. Women’s experiences and preferences regarding breast imaging after completing breast cancer treatment. Patient Prefer Adherence. 2017;11:199–204. CrossRefGoogle Scholar
  19. 19.
    Wernli KJ, Brandzel SD, Buist DSM, Bush M, DeMartini W, Ichikawa L, Haas C, Henderson LM, Johnson D, Kerlikowske K, McColgin D, Miglioretti CL, Nekhlyudov L, Onega T, Rosenberg DE. Comparative effectiveness of surveillance imaging modalities in breast cancer survivors. In press, Final research report to Patient Centered Outcomes Research Institute. 2018.Google Scholar
  20. 20.
    Breast Cancer Surveillance Consortium. 2016 [updated June 2016; Accessed 11/16/17]; Available from: http://www.bcsc-research.org/. Accessed 05/07/2019.
  21. 21.
    Ballard-Barbash R, Taplin SH, Yankaskas BC, Ernster VL, Rosenberg RD, Carney PA, Barlow WE, Geller BM, Kerlikowske K, Edwards BK, Lynch CF, Urban N, Chrvala CA, Key CR, Poplack SP, Worden JK, Kessler LG. Breast Cancer Surveillance Consortium: a national mammography screening and outcomes database. AJR Am J Roentgenol. 1997;169:1001–8.CrossRefGoogle Scholar
  22. 22.
    Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, editors. AJCC cancer staging manual. 7th ed. New York: Springer-Verlag; 2009.Google Scholar
  23. 23.
    Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Shairer C, Mulvihill JJ: Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst. 1989;81(24):1879–86.CrossRefGoogle Scholar
  24. 24.
    Costantino JP, Gail MH, Pee D, Anderson S, Redmond CK, Benichou J, Wieand HS: Validation studies for models projecting the risk of invasive and total breast cancer incidence. J Natl Cancer Inst. 1999;91(18):1541–8.CrossRefGoogle Scholar
  25. 25.
    Gail MH, Costantino JP, Bryant J, Croyle R, Freedman L, Helzlsouer K, Vogel V: Weighing the risks and benefits of tamoxifen treatment for preventing breast cancer. J Natl Cancer Inst. 1999;91(21):1829–46.CrossRefGoogle Scholar
  26. 26.
    Rockhill B, Spiegelman D, Byrne C, Hunter DJ, Colditz GA: Validation of the Gail et al. model of breast cancer risk prediction and implications for chemoprevention. J Natl Cancer Inst. 2001;93(5):358–66.CrossRefGoogle Scholar
  27. 27.
    Gail MH, Costantino JP, Pee D, Bondy M, Newman L, Selvan M, Anderson GL, Malone KE, Marchbanks PA, McCaskill-Stevens W, Norman SA, Simon MS, Spirtas R, Ursin G, and Bernstein L. Projecting Individualized Absolute Invasive Breast Cancer Risk in African American Women. J Natl Cancer Inst. 2007;99(23):1782–1792.CrossRefGoogle Scholar
  28. 28.
    Matsuno RK, Costantino JP, Ziegler RG, Anderson GL, Li H, Pee D, Gail MH. Projecting Individualized Absolute Invasive Breast Cancer Risk in Asian and Pacific Island American Women. J Natl Cancer Inst. 2011;103(12):951–61.CrossRefGoogle Scholar
  29. 29.
    Tice JA, Cummings SR, Smith-Bindman R, et al. Using Clinical Factors and Mammographic Breast Density to Estimate Breast Cancer Risk: Development and Validation of a New Predictive Model. Ann Intern Med. 2008;148(5):337–47.CrossRefGoogle Scholar
  30. 30.
    NCI-funded Breast Cancer Surveillance Consortium (P01 CA154292 and HHSN261201100031C). Downloaded 05/07/2019 from the Breast Cancer Surveillance Consortium Web site - https://tools.bcsc-scc.org/BC5yearRisk. Accessed 05/07/2019.
  31. 31.
    Patel BK, Lee CS, Kosiorek HE et al. Variability of Postsurgical Imaging Surveillance of Breast Cancer Patients: A Nationwide Survey Study. AJR 2018;210:222–227. CrossRefGoogle Scholar
  32. 32.
  33. 33.
    American College of Radiology (ACR) Practice Parameter of Screening and Diagnostic Mammography. https://www.acr.org/-/media/ACR/Files/Practice-Parameters/Dig-Mamo.pdf. Accessed 05/07/2019.
  34. 34.
    Lehman CD, Arao RF, Sprague BL, et al. National Performance Benchmarks for Modern Screening Digital Mammography: Update from the Breast Cancer Surveillance Consortium. Radiology. 2017;283(1):49–58.CrossRefGoogle Scholar
  35. 35.
    Sprague BL, Arao RF, Miglioretti DL, et al. National Performance Benchmarks for Modern Diagnostic Digital Mammography: Update from the Breast Cancer Surveillance Consortium. Radiology. 2017;283(1):59–69.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Louise M. Henderson
    • 1
    Email author
  • Laura Ichikawa
    • 2
  • Diana S. M. Buist
    • 2
  • Janie M. Lee
    • 3
  • Mary Bush
    • 2
  • Dianne Johnson
    • 2
  • Tracy Onega
    • 4
  • Larissa Nekhlyudov
    • 5
  • Karla Kerlikowske
    • 6
    • 7
  • Diana L. Miglioretti
    • 2
    • 8
  • Brian L. Sprague
    • 9
  • Karen J. Wernli
    • 2
  1. 1.Department of Radiology The University of North Carolina Chapel Hill NCChapel HillUSA
  2. 2.Kaiser Permanente Washington Health Research InstituteSeattleUSA
  3. 3.Department of Radiology, Seattle Cancer Care AllianceUniversity of WashingtonSeattleUSA
  4. 4.Department of Biomedical Data ScienceGeisel School of Medicine at DartmouthLebanonUSA
  5. 5.Department of MedicineBrigham and Women’s HospitalBostonUSA
  6. 6.Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoUSA
  7. 7.Department of MedicineUniversity of California, San FranciscoSan FranciscoUSA
  8. 8.Department of Public Health Sciences, School of MedicineUniversity of California, DavisDavisUSA
  9. 9.Department of SurgeryUniversity of Vermont College of MedicineBurlingtonUSA

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