Accuracy of Diagnostic Mammography at Facilities Serving Vulnerable Women
Year: 2010
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Breast cancer missed on diagnostic mammography may contribute to delayed diagnoses, whereas false-positive results may lead to unnecessary invasive procedures. Whether accuracy of diagnostic mammography at facilities serving vulnerable women differs from other facilities is unknown. OBJECTIVE: To compare the interpretive performance of diagnostic mammography at facilities serving vulnerable women to those serving nonvulnerable women. DESIGN: We examined 168,251 diagnostic mammograms performed at Breast Cancer Surveillance Consortium facilities from 1999 to 2005. We used hierarchical logistic regression to compare sensitivity, false positive rates, and cancer detection rates. SUBJECTS: Women aged between 40 and 80 years underwent diagnostic mammography to evaluate an abnormal screening mammogram or breast problem. MEASURES: Facilities were assigned vulnerability indices according to the populations served based on the proportion of mammograms performed on women with lower educational attainment, racial/ethnic minority status, limited household income, or rural residences. RESULTS: Sensitivity of diagnostic mammography did not vary significantly across vulnerability indices adjusted for patient-level characteristics, but false-positive rates for diagnostic mammography examinations to evaluate a breast problem were higher at facilities serving vulnerable women defined as those with lower educational attainment (odds ratio [OR], 1.39; 95% confidence interval [CI]: 1.08, 1.79); racial/ethnic minorities (OR, 1.32; 95% CI: 0.98, 1.76); limited income (OR, 1.34; 95% CI: 1.08, 1.66); and rural residence (OR, 1.55; 95% CI: 1.27, 1.88). CONCLUSIONS: Diagnostic mammography to evaluate a breast problem at facilities serving vulnerable women had higher false positive rates than at facilities serving nonvulnerable women. This may reflect concerns that vulnerable populations may be less likely to follow-up after abnormal diagnostic mammography or concerns that such populations have higher cancer prevalence.
Source: Medical Care
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: EVALUATING AND IMPROVING PRESENT-ON-ADMISSION FOR PERFORMANCE REPORTING, San Francisco Mammography Registry-A Research Source, Clinical and Translational Science Institute, Carolina Mammography Registry, Breast Cancer Surveillance in a Defined Population, Evaluating and Improving Present-On-Admission for Performance Reporting, NEW MEXICO MAMMOGRAPHY PROJECT, Vermont Breast Cancer Surveillance System, Statistical Coordinating Center for the Breast Cancer Surveillance Consortium, New Hampshire Mammography Registry: Strategic Studies in Screening, BREAST CANCER SURVEILLANCE RESEARCH IN COLORADO, Risk of Cancer in Incidental Findings Identified on Ultrasound Imaging
OpenAlex ID: W2005183082