Department of Radiology, The University of North Carolina Chapel Hill NC, Chapel Hill, NC, 27599-7515, USA.
Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
J Gen Intern Med. 2019 Oct;34(10):2098-2106. doi: 10.1007/s11606-019-05181-6. Epub 2019 Aug 13.
National patterns of breast imaging in women with a personal history of breast cancer (PHBC) are unknown making evaluation of annual surveillance recommendations a challenge.
To describe variation in use of mammography and breast magnetic resonance imaging (MRI) examinations beginning 6 months after diagnosis among women with PHBC in US community practice. We report on the breast imaging indication, imaging intervals, and time since breast cancer diagnosis by examination type.
Longitudinal study using cross-sectional data.
Breast Cancer Surveillance Consortium breast imaging facilities.
19,955 women diagnosed between 2005 and 2012 with AJCC stage 0-III incident breast cancer who had 69,386 mammograms and 3,553 breast MRI examinations from January 2005 to September 2013; median follow-up of 37.6 months (interquartile range, 22.1-60.7).
Breast imaging indication, imaging intervals, and time since breast cancer diagnosis by examination type.
Among women with a PHBC who received breast imaging, 89.4% underwent mammography alone, 0.8% MRI alone, and 10.3% had both mammography and MRI. About half of mammograms and MRIs were indicated for surveillance vs. diagnostic, with an increase in the proportion of surveillance exams as time from diagnosis increased (mammograms, 45.7% at 1 year to 72.2% after 5 years; MRIs, 54.8% at 1 year to 78.6% after 5 years). In the first post-diagnosis period, 32.8% of women had > 2 breast imaging examinations and of these, 65.8% were less than 6 months apart. During the first 5-year post-diagnosis, the frequency of examinations per year decreased and the interval between examinations shifted towards annual examinations.
In women with a PHBC who received post-diagnosis imaging, a third underwent multiple breast imaging examinations per year during the first 2-year post-diagnosis despite recommendations for annual exams. As time since diagnosis increases, imaging indication shifts from diagnostic to surveillance.
由于缺乏个人乳腺癌病史（PHBC）女性的全国性乳房影像学模式，评估年度监测建议具有挑战性。
描述美国社区实践中 PHBC 女性在诊断后 6 个月内使用乳房 X 线照相术和乳房磁共振成像（MRI）检查的变化。我们报告了按检查类型划分的乳房影像学指征、成像间隔和自乳腺癌诊断以来的时间。
使用横截面数据的纵向研究。
乳腺癌监测联盟乳房成像设施。
2005 年至 2012 年间诊断出的 AJCC 分期 0-III 期乳腺癌女性 19955 例，共进行了 69386 次乳房 X 线照相术和 3553 次乳房 MRI 检查，检查时间为 2005 年 1 月至 2013 年 9 月；中位随访时间为 37.6 个月（四分位距，22.1-60.7）。
按检查类型划分的乳房影像学指征、成像间隔和自乳腺癌诊断以来的时间。
在接受乳房影像学检查的 PHBC 女性中，89.4%单独接受了乳房 X 线照相术，0.8%单独接受了 MRI，10.3%同时接受了乳房 X 线照相术和 MRI。大约一半的乳房 X 线照相术和 MRI 是为了监测而不是诊断，随着诊断后时间的增加，监测检查的比例增加（乳房 X 线照相术，1 年后为 45.7%，5 年后为 72.2%；MRI，1 年后为 54.8%，5 年后为 78.6%）。在诊断后的第一个时期，32.8%的女性进行了>2 次乳房影像学检查，其中 65.8%的检查间隔不到 6 个月。在诊断后的前 5 年中，每年的检查次数减少，检查间隔向每年一次的检查转移。
在接受诊断后影像学检查的 PHBC 女性中，尽管建议每年进行一次检查，但在诊断后 2 年内，三分之一的人每年进行多次乳房影像学检查。随着诊断后时间的增加，影像学指征从诊断性转变为监测性。
