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Cancer Epidemiol Biomarkers Prev. 2012 Feb;21(2):327-36. doi: 10.1158/1055-9965.EPI-11-0762. Epub 2011 Dec 5.

The impact of obesity on follow-up after an abnormal screening mammogram.

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  • 1Corresponding Author: Ellen A. Schur, Department of General Internal Medicine, Box 359780, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA. ellschur@uw.edu



Effective breast cancer screening and early detection are crucial for obese women, who experience a higher incidence of the disease and present at later stages.


We examined the association between body mass index (BMI) and timeliness of follow-up after 241,222 abnormal screening mammograms carried out on 201,470 women in the Breast Cancer Surveillance Consortium. Each mammogram had one of three recommendations for follow-up: short-interval follow-up, immediate additional diagnostic imaging, and biopsy/surgical consultation. We used logistic regression to estimate the adjusted effect of BMI on any recorded follow-up within 270 days of the recommendation; linear regression was used to model the mean follow-up time among those with recorded follow-up.


As compared with normal-weight women, higher BMI was associated with slightly increased odds of follow-up among women who received a recommendation for short-interval follow-up (ORs: 1.03-1.10; P = 0.04) or immediate additional imaging (ORs: 1.03-1.09; P = 0.01). No association was found for biopsy/surgical consultation recommendations (P = 0.90). Among those with recorded follow-up, higher BMI was associated with longer mean time to follow-up for both short-interval (3-10 days; P < 0.001) and additional imaging recommendations (2-3 days; P < 0.001) but not biopsy/surgical consultation (P = 0.06). Regardless of statistical significance, actual differences in days to follow-up across BMI groups were small and unlikely to be clinically significant.


Once obese women access screening mammography, their follow-up after abnormal results is similar to that of normal-weight women.


Efforts to improve early detection of breast cancer in obese women should focus elsewhere, such as improving participation in screening mammography.

©2011 AACR.

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