Mammography Utilization: Patient Characteristics and Breast Cancer Stage at Diagnosis

Onitilo, Adedayo A., Engel, Jessica M., Liang, Hong, Stankowski, Rachel V., Miskowiak, Douglas A., Broton, Michael and Doi, Suhail A. (2013) Mammography Utilization: Patient Characteristics and Breast Cancer Stage at Diagnosis. American Journal of Roentgenology, 201 5: 1057-1063. doi:10.2214/AJR.13.10733

Author Onitilo, Adedayo A.
Engel, Jessica M.
Liang, Hong
Stankowski, Rachel V.
Miskowiak, Douglas A.
Broton, Michael
Doi, Suhail A.
Title Mammography Utilization: Patient Characteristics and Breast Cancer Stage at Diagnosis
Journal name American Journal of Roentgenology   Check publisher's open access policy
ISSN 0361-803X
Publication date 2013-11-01
Year available 2013
Sub-type Article (original research)
DOI 10.2214/AJR.13.10733
Open Access Status
Volume 201
Issue 5
Start page 1057
End page 1063
Total pages 7
Place of publication Leesburg, United States
Publisher American Roentgen Ray Society
Language eng
Formatted abstract
OBJECTIVE. Missed mammograms represent missed opportunities for earlier breast cancer diagnosis. The purposes of this study were to identify patient characteristics associated with missed mammograms and to examine the association between missed mammograms and breast cancer stage at diagnosis.
MATERIALS AND METHODS. Mammography frequency and cancer stage were retrospectively examined in 1368 cases of primary breast cancer diagnosed at our clinic from 2002 to 2008.
RESULTS. Regardless of age (median, 62.7 years), 1428 women who underwent mammography were more likely to have early-stage (stage 0–II) breast cancer at diagnosis than were those who did not undergo mammography (p < 0.001). Similarly, the number of mammographic examinations in the 5 years before diagnosis was inversely related to stage: 57.3% (94/164) of late-stage cancers were diagnosed in women missing their last five annual mammograms. In a multivariate analysis, family history of breast cancer was most predictive of undergoing mammography (odds ratio, 3.492; 95% CI, 2.616–4.662; p < 0.0001) followed by number of medical encounters (odds ratio, 1.022; 95% CI, 1.017–1.027; p < 0.0001). Time to travel to the nearest mammography center was also predictive of missing mammograms: Each additional minute of travel time decreased the odds of undergoing at least one mammographic examination in the 5 years before cancer diagnosis (odds ratio, 0.990; 95% CI, 0.986–0.993; p < 0.0001).
CONCLUSION. Missing a mammogram, even in the year before a breast cancer diagnosis, increases the chance of a cancer diagnosis at a later stage. Interventions to encourage use of mammography may be of particular benefit to women most likely to miss mammograms, including those with no family history of breast cancer, fewer encounters with the health care system, and greater travel distance to the mammography center.
Keyword Breast cancer screening
Breast neoplasms
Cancer stage
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
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