Determinants of Diagnostic Follow-Up After Inconclusive Screening Mammography

Mammography detects cancer an average of 1.7 years before a woman or her clinician can manually detect it. It is estimated that up to 60 of the women who have an inconclusive mammogram do not return for further medical evaluation, which could possibly detect cancer at an early and possible more treatable stage. Thus, despite the fact that early detection of breast cancer may be life-saving for some women, thousands of women who may be at risk do not follow through to receive a diagnosis. A convenience sample of 202 women from two urban medical centers was invited to participate in the study. All of the women had been notified of their abnormal mammograms within the past two years and instructed to return for further evaluation 81 women returned for diagnostic evaluation and 121 did not return. Telephone interviews are being conducted to provide a greater degree of anonymity and disclosure. A review of the data suggests that women who have not returned for diagnostic follow-up reported receiving less health information concerning their mammograms and appear to have moderate to high levels of cancer fatalism, mild levels of depression, and a lower perception of cancer risk. An outcome of this study is the design of a culturally sensitive protocol to increase adherence to diagnostic evaluation.