Over one-fourth of black women who have abnormal results from mammograms or clinical breast exams still have not resolved the diagnosis with followup tests 6 months later, according to this study which was supported in part by the Agency for Healthcare Research and Quality (HS08395). Delays of this magnitude may compromise survival because for women ultimately determined to have breast cancer, delays of 3 to 6 months have been associated with lower survival rates compared with women who have shorter delays. In this study, black women with prior breast abnormalities or with higher levels of cancer anxiety were about half as likely as others to resolve the diagnosis in 3 to 6 months.
On the other hand, women who reported being told what was to happen next and those who remembered receiving the results of their mammograms were significantly more likely to have diagnostic resolution within 3 months. Improving communication during the mammogram process, particularly if women have had a prior breast abnormality, and ensuring that the patient is told about the next steps to take and fully understands the importance of quick followup may improve followup of abnormal breast cancer screening results, suggest the researchers. They identified 184 black women at three screening clinic sites who had abnormal mammograms or clinical breast exam results that required immediate followup.
The researchers interviewed the women and examined their medical records to assess the association between patient and health care system factors and diagnostic resolution of the abnormal findings within 3 and 6 months. Nearly 37 percent of women reported some kind of symptom at the time of the abnormal finding. Overall, 39 percent of the women were without diagnostic resolution within 3 months and 28 percent within 6 months. Surprisingly, neither socioeconomic status nor system barriers (for example, health insurance status or regular source of primary care) were associated with timely diagnostic resolution.
For more information, see "Realizing the promise of breast cancer screening: Clinical follow-up after abnormal screening among black women," by Jon F. Kerner, Ph.D., Michael Yedidia, Ph.D., Deborah Padgett, Ph.D., and others, in Preventive Medicine 37, pp. 92-101, 2003.