Follow- up screenings crucial for detecting new cancers

April 24, 2006

WORCESTER, MA-Only one in three breast cancer survivors continues to receive recommended surveillance mammograms annually in the five years after cancer treatment, despite dramatically increased risk of recurrence or new malignancy, according to a study to be published in the journal Cancer by University of Massachusetts Medical School (UMMS) researchers that examined mammography use among 797 women over a five-year period. 

"This is an alarming trend," said study author Chyke A. Doubeni, MD, MPH, assistant professor of family medicine & community health at UMMS. "Women with a history of breast cancer face a threefold risk of new or recurrent cancer, so it is imperative that efforts be made to increase awareness among healthcare providers and breast cancer survivors of the value of follow-up mammography." Dr. Doubeni is also a researcher with the Meyers Primary Care Institute, a collaboration between UMMS, Fallon Foundation and Fallon Community Health Plan. 

Annual mammograms are strongly recommended for the 2.3 million American women who have been treated for breast cancer. Mammography has been shown to identify tumors at early stages, when treatment is more successful. 

The researchers found that in the first year after treatment, 80 percent of women had received a screening mammogram. At the fifth year of follow-up, only 63 percent had received a mammogram that year, and only one in three women (33 percent) had received a mammogram each year over the five years. 

The study, to be published in the June issue of Cancer, reveals that the most significant factors predicting which patients received mammograms included being seen by a gynecologist or primary care physician and having been treated with breast-conserving surgery. 

Women who were also being cared for by a gynecologist or primary care physician were the most likely to have yearly or annual mammograms. While the impact of physician specialty in mammography screening has been demonstrated in the general population, this is the first report of this association in breast cancer survivors. In addition, older women, particularly those with other medical conditions, and those diagnosed with late-stage tumors were significantly less likely to have a mammogram. 

Existing studies show that mammography is underutilized by the general population and by Medicare beneficiaries who survived breast cancer. However, little is known about how often survivors with managed care health insurance are screened and how non-financial factors impact its use. Dr. Doubeni and colleagues from four research centers reviewed mammography use in 797 women over the age of 55 who had been treated for breast cancer. Their objective was to identify patterns of mammography utilization in women when health insurance coverage is not a factor. 

The study was conducted by Dr. Doubeni and principle investigator Feifei Wei, PhD, of the HealthPartners Research Foundation in Minneapolis, along with Meyers Primary Care researchers Terry S. Field, DSc, Hassan Fouayzi, MS, and Jerry H. Gurwitz, MD, and colleagues from three other institutions: Marianne Ulcickas Yood, DSc, MPH, who is affiliated with both the Josephine Ford Cancer Center, Henry Ford Health System in Detroit and the Department of Epidemiology and Public Health at Yale University School of Health; Sharon J. Rolnick, PhD, also of the HealthPartners Research Foundation; and Charles P. Quesenberry, PhD, of the Division of Research, Kaiser Permanente Northern California. The study was supported by a grant from the National Cancer Institute to the Cancer Research Network. 

The University of Massachusetts Medical School, one of the fastest growing academic health centers in the country, has built a reputation as a world-class research institution, consistently producing noteworthy advances in clinical and basic research.  The Medical School attracts more than $174 million in research funding annually, 80 percent of which comes from federal funding sources. For more information visit 

Contact: Alison Duffy