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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.



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.

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