Recent News and Articles on the Keywords: cancer + survivors + mammogram  Related to the article below (Last Update: 8/7/2008)

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Many Breast Cancer Survivors Neglect Mammograms

Summary: Many breast cancer survivors don't keep up with their mammograms after their treatment has ended, according to a new study. And the longer it's been since their original diagnosis, the less likely they are to be on schedule, researchers say in the journal Cancer.

Why it's important: Women who have already had breast cancer are 3-4 times as likely to develop a new tumor (in the same breast or the other one) as women who've never had the disease. They are also at risk of having their cancer return in the same breast if they didn't have a mastectomy. Regular mammograms can help find recurrences or new cancers at an early stage, when they are easier to treat.

What's already known: Many studies have shown that women who have never had breast cancer often fail to get their mammograms every year. There hasn't been as much research on mammogram use in women who've survived the disease, but there have been some studies that show even survivors don't keep up with their screening. That's a concern because there are about 2.3 million breast cancer survivors in the US, according to statistics cited by Chyke A. Doubeni, MD, MPH, and colleagues. Doubeni is in the Department of Family Medicine and Community Health at the University of Massachusetts Medical Center.

How this study was done: Doubeni and his colleagues studied the medical records of nearly 800 women who were enrolled in 4 different health maintenance organizations (HMOs).. All the women had been diagnosed with breast cancer in 1996 or 1997. The researchers looked at how often the women who stayed in their health plan got mammograms, starting 13 months after their diagnosis (to account for treatment time). They tracked the women for 5 years.

What was found: The number of women remaining in their health plan declined over time as women died or left the plan. But the percentage of women having regular mammograms also went down over time. In the first year after treatment, 80% of the 797 women had a mammogram. By the fifth year, though, just 63% of the 262 women remaining in the HMOs had a mammogram. And just 33% of these women had had a mammogram each of the previous 5 years, as she should have.

Women who neglected their mammograms tended to be older than 75 and have other illnesses. Women who'd been treated with mastectomy were also less likely to get mammograms, compared to women who'd had breast-conserving surgery (lumpectomy), but no other treatments (chemotherapy, radiation or hormone therapy) had an impact on who followed screening recommendations. Women who regularly saw a gynecologist or primary care physician were most likely to keep up with screening.

The study did not look at whether any of these women got a recurrence of breast cancer, or how many of them died of breast cancer or any other cause.

The researchers also did not ask the women why they stopped getting their mammograms -- but Doubeni and his colleagues have some ideas. It may be that the farther women get from their treatment, the less concerned they become about getting breast cancer again. Or it could be that mammograms fall through the cracks as women transition from seeing their oncologist to seeing a primary care doctor again.

The bottom line: The study findings show how important it is for primary care doctors and gynecologists to get involved in the follow-up care of their patients who are also breast cancer survivors, Doubeni and his colleagues write. They recommend better coordination between oncologists and the doctors who will care for these survivors after their cancer treatment has ended. They also suggest that women get a written follow-up plan after breast cancer treatment, a strategy first recommended by the Institute of Medicine.