Time to Diagnostic Evaluation After Mammographic Screening in an Urban Setting

• Published in: Journal of women's health (Larchmont, N.Y. 2002) Vol. 25; no. 12; p. 1225
• Main Authors: Oppong, Bridget A, Dash, Chiranjeev, Coleman, Tesha, Torres, Tanya, Adams-Campbell, Lucile L
• Format: Journal Article
• Language: English
• Published: United States 01.12.2016
• Subjects: African Americans - statistics & numerical data; Breast Neoplasms - diagnosis; Breast Neoplasms - prevention & control; Continuity of Patient Care; Delivery of Health Care - organization & administration; Early Detection of Cancer; Female; Follow-Up Studies; Hispanic Americans - statistics & numerical data; Humans; Mammography; Mass Screening; Minority Health; Patient Compliance; Patient Navigation; Patient-Centered Care; Prospective Studies; Socioeconomic Factors; Time Factors; Time-to-Treatment; Urban Population - statistics & numerical data; patient navigation; minority health; breast cancer; screening mammography; diagnostic
• ISSN: 1931-843X
• DOI: 10.1089/jwh.2015.5661

The Capital Breast Care Center (CBCC), a screening facility established to serve minority women, developed a culturally sensitive patient care paradigm that would address concerns of adherence to follow-up of abnormal results after initial mammogram. Women with abnormal mammograms are assigned a Black or Latina navigator who facilitates the additional workup needed by scheduling follow-up, arranging transportation, providing counsel/emotional support, and even accompanying them to diagnostic imaging or biopsy appointment. We present data on follow-up rates after breast cancer screening. All patients seen at CBCC are entered into a prospectively collected database. We calculated intervals (in days) between the screening and diagnostic visits. Descriptive statistics and median time to follow-up are reported. Differences between Black and Hispanic women on time interval were tested by t-test. From January 2010 to December 2012, 4605 digital screening mammograms were performed. Fifty-two percent of the women self-identified as Black, 41% as Hispanic, 4% White, 2% Asian, and 1% as "other." Of the screening studies, 451 (9.8%) required additional workup, out of which 362 (80%) of the women returned for the recommended diagnostic imaging. The median interval between screening and diagnostic imaging was 39 days (range: 6-400). Of the 162 women recommended to have a core needle biopsy, 81.5% underwent biopsy within a median of 21 days (range: 0-221 days). At the CBCC, time to patient follow-up after initial mammographic screening is within the CDC-recommended performance standard of less than 60 days. For a population that historically has low rates of clinical follow-up, we attribute this reduction in delays to breast cancer diagnostic resolution to a culturally sensitive patient navigation program. Additional studies are needed to assess how the existing navigation program can be individualized/tailored to target the remaining 20% of women who did not adhere to the recommended workup.