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April 25, 2006

Breast cancer survivors skip mammograms

More than one third of breast cancer survivors gradually stop getting annual mammograms, according to a new study.

The results may indicate that women grow complacent about medical screening once they get past the medical scare, said the
study’s lead author, Chyke Doubeni of the University of Massachusetts. Others said it’s more likely survivors avoid screenings because they dread a recurrence of the cancer and additional treatment.

“They’re fearful something’s going to be found,” said Kathryn Edmiston, a Worcester, Mass., oncologist who specializes in treating breast cancer patients.

The study found just 63% of women were getting annual mammograms five years after breast cancer surgery. The findings were reported in Cancer, a medical journal published by the Atlanta-based American Cancer Society.

About 2.3 million U.S. women have been treated for breast cancer, and they are considered to be at three times the risk for tumors in the unaffected breast than women with no such medical history.

Studies also have shown that lesbians are at a higher risk for breast cancer than their heterosexual peers.

The American Cancer Society recommends all women 40 and older get an annual mammogram, the procedure for taking an X-ray of the breast. But studies have shown only about 58% of women over 40 actually do. Few studies have looked at how often breast cancer survivors get mammograms.

“The assumption has been that once women have had breast cancer, they’re going to recognize the value of a mammography and get it done,” Edmiston said.

In this study, researchers reviewed medical records for 797 women who were diagnosed with breast cancer in 1996 or 1997. All were 55 and older, and the average age was approximately 69.5. All received care from health systems in Detroit, Minneapolis, Oakland, Calif., or Worcester, Mass. More than 80% were white.

About 40% had undergone the removal of one breast, and 55% had undergone a lumpectomy or some other form of breast-conserving surgery. Women who’d had double mastectomies were not included.

About 80% of the women had mammograms within the first year after surgery, but the percentage dropped to 63% by the fifth year, the study found.

Older women, particularly those with other ailments, were less likely to get the tests as the years went by. Women who saw a doctor annually were more likely to get them.

Also, women who'd undergone breast-conserving treatment were more likely to get mammograms than women who’d had a mastectomy.

It’s possible that both complacency and fear may be keeping some women from follow-up mammograms, said Robert Smith, the American Cancer Society’s director of cancer screening.

Also, doctors may be failing to remind women to get the exams. “The recommendation and endorsement of physicians can overcome those issues” of fear and complacency, Smith said. (AP, with additional reporting by The Advocate)

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