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Surveillance for cancer recurrence in long-term young breast cancer survivors randomly selected from a statewide cancer registry

  • Epidemiology
  • Published:
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Abstract

Purpose

This study examined clinical breast exam (CBE) and mammography surveillance in long-term young breast cancer survivors (YBCS) and identified barriers and facilitators to cancer surveillance practices.

Methods

Data collected with a self-administered survey from a statewide, randomly selected sample of YBCS diagnosed with invasive breast cancer or ductal carcinoma in situ younger than 45 years old, stratified by race (Black vs. White/Other). Multivariate logistic regression models identified predictors of annual CBEs and mammograms.

Results

Among 859 YBCS (n = 340 Black; n = 519 White/Other; mean age = 51.0 ± 5.9; diagnosed 11.0 ± 4.0 years ago), the majority (> 85%) reported an annual CBE and a mammogram. Black YBCS in the study were more likely to report lower rates of annual mammography and more barriers accessing care compared to White/Other YBCS. Having a routine source of care, confidence to use healthcare services, perceived expectations from family members and healthcare providers to engage in cancer surveillance, and motivation to comply with these expectations were significant predictors of having annual CBEs and annual mammograms. Cost-related lack of access to care was a significant barrier to annual mammograms.

Conclusions

Routine source of post-treatment care facilitated breast cancer surveillance above national average rates. Persistent disparities regarding access to mammography surveillance were identified for Black YBCS, primarily due to lack of access to routine source of care and high out-of-pocket costs.

Implications

Public health action targeting cancer surveillance in YBCS should ensure routine source of post-treatment care and address cost-related barriers. Clinical Trials Registration Number: NCT01612338.

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Acknowledgements

Joan Such Lockhart, PhD, RN, CORLN, AOCN, CNE, ANEF, FAAN, and Sr. Rosemary Donley, PhD, APRN from Duquesne University School of Nursing, 600 Forbes Avenue, Pittsburgh, PA 15282, USA for providing support and guidance to Dr. Tarsha Jones while she completed her doctoral studies at Duquesne University School of Nursing. Jenna McLosky, CGC, Cancer Genomics Program—Michigan Department of Health and Human Services for patient and relative identification, recruitment, and assessment of eligibility.

Funding

Centers for Disease Control and Prevention, 5U48DP001901-03, PI: M.C. Katapodi. Robert Wood Johnson Foundation, Nurse Faculty Scholars Award 68039, PI: M.C. Katapodi.

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Authors and Affiliations

  1. Florida Atlantic University Christine E. Lynn College of Nursing, 777 Glades Road, Boca Raton, FL, 33431, USA

    Tarsha Jones

  2. Feinberg School of Medicine, Northwestern University, Arkes Family Pavilion Suite 600, 676 N Saint Clair, Chicago, IL, 60611, USA

    Debra Duquette

  3. The Phyllis F. Cantor Center for Research in Nursing & Patient Care Services, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA

    Meghan Underhill

  4. Nursing Science, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland

    Chang Ming & Maria C. Katapodi

  5. University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA

    Kari E. Mendelsohn-Victor, Laurel L. Northouse & Maria C. Katapodi

  6. Michigan Department of Health and Human Services, 333 S. Grand Ave., P.O. Box 30195, Lansing, MI, 48909, USA

    Beth Anderson

  7. University of Michigan Comprehensive Cancer Center, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA

    Kara J. Milliron

  8. Michigan Cancer Surveillance Program, 333 S. Grand Ave., P.O. Box 30195, Lansing, MI, 48909, USA

    Glenn Copeland

  9. School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA

    Nancy K. Janz & Sofia D. Merajver

  10. Ohio State University College of Nursing, 1585 Neil Ave, Columbus, OH, 43210, USA

    Sonia M. Duffy

  11. School of Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA

    Sofia D. Merajver

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  1. Tarsha Jones
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  2. Debra Duquette
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Correspondence to Maria C. Katapodi.

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Conflict of interest

Tarsha Jones, Debra Duquette, Meghan Underhill, Kari E. Mendelsohn-Victor, Beth Anderson, Chang Ming, Kara J. Milliron, Glenn Copeland, Nancy K. Janz, Laurel L. Northouse, Sonia M. Duffy, Sofia D. Merajver, and Maria C. Katapodi declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Jones, T., Duquette, D., Underhill, M. et al. Surveillance for cancer recurrence in long-term young breast cancer survivors randomly selected from a statewide cancer registry. Breast Cancer Res Treat 169, 141–152 (2018). https://doi.org/10.1007/s10549-018-4674-5

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