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Radiology. 2011 Nov;261(2):404-13. doi: 10.1148/radiol.11102472. Epub 2011 Sep 7.

Timeliness of follow-up after abnormal screening mammogram: variability of facilities.

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  • 1Department of Radiology, University of New Mexico-HSC, 1 University of New Mexico, HSC 10 5530, Albuquerque, NM 87131-0001, USA. rrosenb@unm.edu

Abstract

PURPOSE:

To describe the timeliness of follow-up care in community-based settings among women who receive a recommendation for immediate follow-up during the screening mammography process and how follow-up timeliness varies according to facility and facility-level characteristics.

MATERIALS AND METHODS:

This was an institutional review board-approved and HIPAA-compliant study. Screening mammograms obtained from 1996 to 2007 in women 40-80 years old in the Breast Cancer Surveillance Consortium were examined. Inclusion criteria were a recommendation for immediate follow-up at screening, or subsequent imaging, and observed follow-up within 180 days of the recommendation. Recommendations for additional imaging (AI) and biopsy or surgical consultation (BSC) were analyzed separately. The distribution of time to follow-up care was estimated by using the Kaplan-Meier estimator.

RESULTS:

Data were available on 214,897 AI recommendations from 118 facilities and 35,622 BSC recommendations from 101 facilities. The median time to subsequent follow-up care after recommendation was 14 days for AI and 16 days for BSC. Approximately 90% of AI follow-up and 81% of BSC follow-up occurred within 30 days. Facilities with higher recall rates tended to have longer AI follow-up times (P < .001). Over the study period, BSC follow-up rates at 15 and 30 days improved (P < .001). Follow-up times varied substantially across facilities. Timely follow-up was associated with larger volumes of the recommended procedures but not notably associated with facility type nor observed facility-level characteristics.

CONCLUSION:

Most patients with follow-up returned within 3 weeks of the recommendation.

RSNA, 2011

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