Department of Oncology, Mayo Clinic, Rochester, MN, USA.
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
Breast Cancer Res Treat. 2022 Aug;194(3):693-698. doi: 10.1007/s10549-022-06645-w. Epub 2022 Jun 17.
To identify the practice patterns related to use of surveillance mammography in male breast cancer (MaBC) survivors.
Using administrative claims data from OptumLabs Data Warehouse, we identified men who underwent surgery for breast cancer during 2007-2017. We calculated the proportion of men who had at least one mammogram (a) within 13 months for all patients and (b) within 24 months amongst those who maintained their insurance coverage for at least that length of time after surgery. Multivariate logistic regression modeling was used to identify factors associated with mammography within each timeframe.
Out of 729 total MaBC survivors, 209 (29%) underwent mammography within 13 months after surgery. Among those who had lumpectomy, 41% underwent mammography, whereas among those who had mastectomy, 27% had mammography. Amongst 526 men who maintained consistent insurance coverage for 24 months after surgery, 215 (41%) underwent mammography at least once during that 24-month period. In this cohort, the proportion who had at least one mammogram during the 24-month period was 49% after lumpectomy and 40% after mastectomy. In a multivariate logistic regression model, more recent diagnosis (2015+) and older age at diagnosis were associated with lower odds of undergoing mammography, while receipt of radiation was associated with higher odds of undergoing mammography.
Although recent ASCO guidelines recommend surveillance mammography after lumpectomy, a minority of MaBC survivors undergo surveillance mammography, even after lumpectomy. This is likely due to the paucity of data regarding the true benefits and harms of surveillance/screening mammography for MaBC.
确定与男性乳腺癌（MaBC）幸存者使用监测性乳房 X 线照相术相关的实践模式。
使用 OptumLabs Data Warehouse 的行政索赔数据，我们确定了在 2007 年至 2017 年间接受乳房癌手术的男性。我们计算了至少进行一次乳房 X 光检查的男性比例（a）所有患者在手术后 13 个月内，以及（b）在手术后至少有那么长时间保持保险覆盖的患者中，在 24 个月内。使用多变量逻辑回归模型来确定每个时间段内与乳房 X 光检查相关的因素。
在 729 名总 MaBC 幸存者中，有 209 名（29%）在手术后 13 个月内进行了乳房 X 光检查。在接受保乳手术的患者中，有 41%进行了乳房 X 光检查，而在接受乳房切除术的患者中，有 27%进行了乳房 X 光检查。在 526 名手术后至少有 24 个月持续保险的男性中，有 215 名（41%）在这 24 个月期间至少进行了一次乳房 X 光检查。在该队列中，在 24 个月期间至少进行一次乳房 X 光检查的比例为保乳手术后的 49%和乳房切除术的 40%。在多变量逻辑回归模型中，较晚的诊断（2015 年及以后）和诊断时年龄较大与进行乳房 X 光检查的可能性较低相关，而接受放射治疗与进行乳房 X 光检查的可能性较高相关。
尽管最近的 ASCO 指南建议在保乳手术后进行监测性乳房 X 光检查，但少数 MaBC 幸存者接受了监测性乳房 X 光检查，即使在保乳手术后也是如此。这可能是由于缺乏有关 MaBC 监测/筛查乳房 X 光检查的真正益处和危害的数据所致。
