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Showing content from https://pubmed.ncbi.nlm.nih.gov/31669081/ below:

Factors Associated With Optimal Follow-up in Women With BI-RADS 3 Breast Findings

. 2020 Apr;17(4):469-474. doi: 10.1016/j.jacr.2019.10.003. Epub 2019 Oct 26. Factors Associated With Optimal Follow-up in Women With BI-RADS 3 Breast Findings

Affiliations

¹ Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: rlacson@rics.bwh.harvard.edu.
² Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts.
³ Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
⁴ Harvard Medical School, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
⁵ Harvard Medical School, Boston, Massachusetts; Department of Anesthesiology, Brigham and Women's Hospital, Boston, Massachusetts.

PMID: 31669081
PMCID: PMC7509994
DOI: 10.1016/j.jacr.2019.10.003

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Factors Associated With Optimal Follow-up in Women With BI-RADS 3 Breast Findings

Ronilda Lacson et al. J Am Coll Radiol. 2020 Apr.

. 2020 Apr;17(4):469-474. doi: 10.1016/j.jacr.2019.10.003. Epub 2019 Oct 26. Affiliations

¹ Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: rlacson@rics.bwh.harvard.edu.
² Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts.
³ Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
⁴ Harvard Medical School, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
⁵ Harvard Medical School, Boston, Massachusetts; Department of Anesthesiology, Brigham and Women's Hospital, Boston, Massachusetts.

PMID: 31669081
PMCID: PMC7509994
DOI: 10.1016/j.jacr.2019.10.003

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Abstract

Objective: Assess rate of and factors associated with optimal follow-up in patients with BI-RADS 3 breast findings.

Methods: This Institutional Review Board-approved, retrospective cohort study, performed at an academic medical center, included all women undergoing breast imaging (ultrasound and mammography) in 2016. Index reports for unique patients with an assessment of BI-RADS 3 (retrieved via natural language processing) comprised the study population. Patient-specific and provider-related features were extracted from the Research Data Warehouse. The Institutional Cancer Registry identified patients diagnosed with breast cancer. Optimal follow-up rate was calculated as patients with follow-up imaging on the same breast 3 to 9 months from the index examination among patients with BI-RADS 3 assessments. Univariate analysis and multivariable logistic regression determined features associated with optimal follow-up. Malignancy rate and time to malignancy detection were recorded.

Results: Among 93,685 breast imaging examinations, 64,771 were from unique patients of which 2,967 had BI-RADS 3 findings (4.6%). Excluding patients with off-site index examinations and those with another breast examination <3 months from the index, 1,125 of 1,511 patients (74%) had optimal follow-up. In univariate and multivariable analysis, prior breast cancer was associated with optimal follow-up; younger age, Hispanic ethnicity, divorced status, and lack of insurance were associated with not having optimal follow-up. Malignancy rate was 0.86%, and mean time to detection was 330 days.

Discussion: Follow-up of BI-RADS 3 breast imaging findings is optimal in only 74% of women. Further interventions to promote follow-up should target younger, unmarried women, those with Hispanic ethnicity, and women without history of breast cancer and without insurance coverage.

Keywords: BI-RADS; breast imaging; follow-up; health disparities; mammography.

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