New findings presented at the 2016 Clinical Congress of the American College of Surgeons revealed that of the patients diagnosed with breast cancer, nearly one-third are not receiving annual mammograms post-treatment.1 The researchers assessed imaging, cancer recurrence, new cancer, and death from the time of treatment and for five years after diagnosis. Next, they collected additional data on the reason for imaging (diagnostic evaluation of a new sign or symptom or surveillance imaging in the absence of signs and symptoms). Fifty percent of the study population was under age 60.
“The most striking finding is that over 30% of women don’t even get surveillance breast imaging in the first place,” said Caprice C. Greenberg, MD, MPH, FACS, University of Wisconsin School of Medicine and Public Health. “For some reason, we are not plugging them into follow-up surveillance from the outset. We also see that there are some disparities in the use of mammograms after the treatment of breast cancer.”
A summary of their findings are quite striking. Basic principles outlined by this research indicate:
Women are not given guideline recommendations for follow-up imaging.
Disparities still exist with the greatest factors associated with not receiving breast imaging include younger age, uninsured or underinsured, advanced disease, and being African American.
The bulk of the disparity seems to occur in that first year of follow up.
MRI, being appropriate for some patients, but guidelines do not recommend this study as routine.
Why cancer survivors are not receiving appropriate surveillance is a high priority. Guidelines are available, but underutilized and the variation in its utilization impacts patient care and outcomes.
For those of us who work in accredited breast programs, we know that there are mandatory standards in which a survivorship care plan must be distributed to the patient after active treatment. They must be personalized to the patient’s situation and follow-up guidelines are the core template used.
This research was based on data collected from nearly a decade ago, and I would like to consider that patient care plans have been better utilized now. If we are still missing the foundation of survivorship in extending the best possible outcome for a healthy and meaningful postcancer treatment quality of life, then we still have much to do indeed.
American College of Surgeons. One-third of Women Treated for Breast Cancer Are Not Getting Appropriate Breast Imaging Follow-up Exam, New Study Finds. 2016 Oct 19.
Male breast cancer accounts for about 1% of all breast cancer cases in the United States, therefore it can be a shocking diagnosis. During my career as a nurse practitioner in the field of breast oncology, I have been involved in the care of only five male breast cancer cases over the last 25 years.
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