Doubeni Chyke A, Field Terry S, Ulcickas Yood Marianne, Rolnick Sharon J, Quessenberry Charles P, Fouayzi Hassan, Gurwitz Jerry H, Wei Feifei
Department of Family Medicine and Community Health, University of Massachusetts, Worcester, Massachusetts 01655, USA.
Cancer. 2006 Jun 1;106(11):2482-8. doi: 10.1002/cncr.21893.
Improvements in cancer detection and treatment have resulted in increasing numbers of breast cancer survivors. Information regarding the use of mammography by breast cancer survivors is limited.
The use of surveillance mammography was examined over a 5-year period in a retrospective cohort of women age>or=55 years who were diagnosed with incident primary breast cancer (1996-1997) while enrolled in 1 of 4 geographically diverse integrated health systems.
Of the 797 women included in the study, 80% (n=636) underwent mammograms during the first year after treatment for breast cancer. The percentage of women having mammograms during each yearly period decreased significantly over time. In multivariable analyses, older women with comorbid illnesses or those with late-stage disease were less likely to undergo mammograms, whereas those who underwent breast-conserving therapy (adjusted odds ratio [OR] of 1.38 [95% confidence interval (95% CI), 1.09-1.75]) were more likely to have mammograms. Women who had outpatient visits with a gynecologist (adjusted OR of 3.49 [95% CI, 2.55-4.79]), or a primary care physician (adjusted OR of 2.21 [95% CI, 1.73-2.82]) during the year were more likely to undergo mammograms in that year.
The use of mammography among breast cancer survivors declines over time. Efforts are needed to increase awareness among healthcare providers and breast cancer survivors of the value of follow-up mammography. The current findings highlight the importance of maintaining ongoing contact with primary care physicians and gynecologists.
癌症检测和治疗方面的进步使得乳腺癌幸存者的数量不断增加。关于乳腺癌幸存者乳腺X线摄影使用情况的信息有限。
在一个回顾性队列研究中，对年龄≥55岁、在1996 - 1997年被诊断为原发性乳腺癌且参与4个地理区域不同的综合医疗系统之一的女性进行了为期5年的监测乳腺X线摄影使用情况的研究。
在纳入研究的797名女性中，80%（n = 636）在乳腺癌治疗后的第一年接受了乳腺X线摄影检查。随着时间推移，每年接受乳腺X线摄影检查的女性比例显著下降。在多变量分析中，患有合并症的老年女性或晚期疾病患者接受乳腺X线摄影检查的可能性较小，而接受保乳治疗的女性（调整后的优势比[OR]为1.38[95%置信区间（95%CI），1.09 - 1.75]）接受乳腺X线摄影检查的可能性更大。在当年门诊就诊于妇科医生（调整后的OR为3.49[95%CI，2.55 - 4.79]）或初级保健医生（调整后的OR为2.21[95%CI，1.73 - 2.82]）的女性在当年接受乳腺X线摄影检查的可能性更大。
乳腺癌幸存者乳腺X线摄影的使用随时间而减少。需要努力提高医疗服务提供者和乳腺癌幸存者对后续乳腺X线摄影价值的认识。目前的研究结果突出了与初级保健医生和妇科医生保持持续联系的重要性。
