Reply to “Women Successfully Treated for Breast Cancer Can Return Immediately to Annual Screening”

2021 ◽  
pp. 1-2
Author(s):  
Emily B. Ambinder ◽  
Kelly S. Myers ◽  
Eniola Oluyemi ◽  
Babita Panigrahi ◽  
Lisa A. Mullen
Keyword(s):  
Breast Cancer ◽  
Annual Screening

Continuation of Annual Screening Mammography and Breast Cancer Mortality in Women Older Than 70 Years

2020 ◽  
Vol 172 (6) ◽  
pp. 381 ◽  
Author(s):  
Xabier García-Albéniz ◽  
Miguel A. Hernán ◽  
Roger W. Logan ◽  
Mary Price ◽  
Katrina Armstrong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Screening Mammography ◽  
Annual Screening

scholarly journals Continuation of annual screening mammograms and breast-cancer mortality in women over 70

2019 ◽  
Vol 30 ◽  
pp. v675-v676
Author(s):  
X Garcia De Albeniz ◽  
M. Hernán ◽  
R. Logan ◽  
M. Price ◽  
J. Hsu
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Annual Screening ◽  
Screening Mammograms

National survey of breast cancer screening in rural America.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 13-13 ◽  
Author(s):  
Jeffrey M. Peppercorn ◽  
Kevin Houck ◽  
Adane Fekadu Wogu ◽  
Victor Villagra ◽  
Gary H. Lyman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Rural Women ◽  
Rural Areas ◽  
Univariate Analysis ◽  
College Education ◽  
Screening Mammography ◽  
Screening Methods ◽  
Annual Screening

13 Background: Screening mammography leads to early detection of breast cancer and improved survival. We conducted a survey of predominantly rural U.S. women who receive health insurance through the National Rural Electric Cooperative Association (NRECA) to evaluate the prevalence of annual and biennial screening and to identify potential disparities and barriers to breast cancer screening. Methods: We conducted a national cross-sectional survey of women between ages 40 and 65 who are insured by the NRECA regarding their utilization of mammography screening and barriers to screening. A study specific survey was mailed to 2,000 randomly selected eligible women without prior diagnosis of breast cancer. We assessed demographics and receipt of mammography within past 12 months (all women) and number of screening mammograms within the past 4 years (among women age 44 and older) to identify consistent annual screening and biennial screening patterns. Results: 1,204 women responded to the survey (response rate 60.2%). 74% live in rural areas, 18% suburban, 8% urban. 73% report less than 4 years college education and 19% have family incomes < $50,000/year. Overall, 72% reported screening mammography within 12 months, 59% reported consistent annual screening and 84% reported at least biennial screening. Rural women were less likely to undergo consistent annual (56% vs. 66%, p = 0.003) or biennial screening (82% vs. 89%, p = 0.01) compared to women in non-rural areas. Women under 50 were less likely to report screening within 12 months (67% vs. 77%, p = 0.0002), consistent annual (49% vs. 63%, p < 0.0001) or biennial screening (79% vs. 86%, p = 0.002). Significantly more rural women cited cost and distance as barriers, while busy schedule, fear of diagnosis, and fear of discomfort were important barriers among all demographic groups. Fear of the test was a greater barrier among younger vs. older women (p < 0.02). In univariate analysis; household income did not correlate with screening, and education was only a factor among younger women. Conclusions: A substantial percentage of rural U.S. women fail to undergo screening mammography. Potentially modifiable barriers include out of pocket expenses, convenience of screening, and fear of diagnosis and the test itself.

Utilization and costs of breast cancer screening for women in their 40s in a privately insured U.S. population.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 105-105
Author(s):  
Natalia R. Kunst ◽  
Jessica B. Long ◽  
Xiao Xu ◽  
Susan Busch ◽  
Ilana Richman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Annual Cost ◽  
Median Cost ◽  
Data Set ◽  
Screening Strategies ◽  
Annual Screening ◽  
The Cost ◽  
Privately Insured

105 Background: Despite ongoing debate about the effectiveness of initiating breast cancer screening at age 40, there is less attention paid to costs implications associated with the alternative screening starting ages. We assessed the annual costs of different screening strategies for privately insured women aged 40-49, as well as regional cost variation. Methods: We used a limited data set from Blue Cross Blue Shield (BCBS) Axis, the largest source of commercial US claims data. We identified the unit costs and frequencies of screening and subsequent evaluation for beneficiaries with continuous coverage through 2017. A Monte Carlo simulation model was developed to evaluate the annual costs of three alternate screening strategies: 1) current clinical practice, 2) annual screening beginning at age 40, or 3) annual screening beginning at age 45. The following procedures were included: screening (2-D and 3-D mammogram), supplementary ultrasound, recall (diagnostic 2-D and 3-D mammogram and ultrasound), MRI, and biopsy. We examined variability in screening-related costs across hospital referral regions (HRRs), and identified the main contributors to regional variation. Results: Overall, 69% of women in their 40s received a mammogram in 2017, resulting in an annual cost of $200 per beneficiary. This cost varied nine-fold across HRRs (range: $60-550 per beneficiary). The median cost of mammograms varied substantially across regions (2-D median cost: $206; range: $100-463; 3-D median: $271; range: $104-676). Variability in the cost of 2-D and 3-D mammogram was the main contributor to the variation in annual screening-related costs across HRRs, explaining 37% and 27% of the total variation, respectively. Screening all women beginning at age 40 would be associated with an annual cost of $309 per beneficiary (range: $127-664). Initiating screening at age 45 would cost $153 per beneficiary (range: $61-319). Conclusions: In current practice, breast cancer screening in women ages 40-49 is common, and costs $200 per eligible female beneficiary annually. Screening all women beginning at age 40 would increase the median screening-related costs by over 50%, although the cost implications vary substantially across regions.

scholarly journals BRCA Mutations and Breast Cancer Prevention

Cancers ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 524 ◽  
Author(s):  
Joanne Kotsopoulos
Keyword(s):  
Breast Cancer ◽  
Brca Mutation ◽  
Brca2 Mutation ◽  
Bilateral Mastectomy ◽  
Resonance Imaging ◽  
Brca Mutations ◽  
Annual Screening ◽  
Brca Mutation Carriers ◽  
Magnetic Resonance Imaging Mri ◽  
Prevention Of Breast Cancer

Women who inherit a deleterious BRCA1 or BRCA2 mutation face substantially increased risks of developing breast cancer, which is estimated at 70%. Although annual screening with magnetic resonance imaging (MRI) and mammography promotes the earlier detection of the disease, the gold standard for the primary prevention of breast cancer remains bilateral mastectomy. In the current paper, I review the evidence regarding the management of healthy BRCA mutation carriers, including key risk factors and protective factors, and also discuss potential chemoprevention options. I also provide an overview of the key findings from the literature published to date, with a focus on data from studies that are well-powered, and preferably prospective in nature.

BPI19-012: Differences in Stakeholder Perspectives Regarding Key Components of Shared Decision-Making for Mammography in Breast Cancer Screening for Women Ages 40–50

2019 ◽  
Vol 17 (3.5) ◽  
pp. BPI19-012
Author(s):  
Lori L. DuBenske ◽  
Sarina B. Schrager ◽  
Terry A. Little ◽  
Elizabeth S. Burnside
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Shared Decision Making ◽  
Average Risk ◽  
Shared Decision ◽  
Delphi Consensus ◽  
Annual Screening ◽  
Core Elements

Background: National health organizations offer contrasting guidelines for women aged 40–49 regarding when to begin and how often to use mammography screening for breast cancer. The ACS recommends average risk women aged 40–44 receive annual screening “if they wish to do so” and annual screening for women aged 45–54. The United States Preventive Services Task Force recommends individualized screening for average-risk women before age 50 advised by risk assessment and shared decision-making (SDM). Clinicians lack guidance on how to conduct and what elements to include in mammography SDM. Our prior work identified core elements via scoping review applied to a modified Delphi consensus process involving patients, primary care physicians (PCP), and healthcare decision scientists (HDS). This study examines stakeholder group differences in endorsing core SDM elements. Methods: The Delphi consensus included 10 patients, 10 PCP, and 10 HDS and fielded 48 items to codify core elements of mammography SDM. A threshold of 80% agreement across all participants was set to establish consensus for retaining or dropping an item. In this study, separate stakeholder groups’ endorsement rates for each item were calculated. Items were deemed to have stakeholder discrepancy if one group differed from the 2 others in either meeting or not meeting the 80% threshold criteria. Results: 16 items (13 retained, 3 dropped in Delphi) had a discrepant group. For all retained items, the discrepant group fell below 80% criteria for retaining. For 2 of the dropped items, discrepant groups achieved threshold for retaining the item. One item was dropped despite most participants voting to retain it (>80%) due to the discrepant group’s rating <80%. Patients rated less importance to educating women about risks and recommendations. PCPs rated lower importance to training PCPs and women for discussions about mammograms and having discussions on a regular basis. HDSs rated greater importance to considering mammogram procedures and costs in SDM. Discussion: Leading healthcare organizations are increasingly recommending SDM in breast cancer screening, among other decisions. Guidelines enumerating core elements of SDM are needed to effectively direct clinicians. This study, by illuminating differences between stakeholder group perspectives, highlights the importance of eliciting varied perspectives in identifying core elements of SDM when informing healthcare practices and policy.

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