Surveillance after Initial Treatment for Breast Cancer: A Population-based Study of Variation In and Outcomes of Care

A cohort was assembled of 3885 women from the Surveillance, Epidemiology, and End Results SEER Registry, who were aged 65 or older at the time of diagnosis of early stage breast cancer in 1991, who underwent initial surgical treatment, and for whom Medicare claims could be linked. During the two years following the initial treatment period, 62 underwent annual mammography, and 85 had at least one mammogram. When controlling for other factors, including age, stage, and geographic site, women were less likely to receive annual mammography if initially treated with breast-conserving surgery BCS without radiation OR 0.36, 95 CI0.28, 0.45 or mastectomy, OR 0.43, 95 CI0.36, 0.52 compared to women initially treated with BCS with radiation. Women with initial stage I OR 0.75, 95 CI0.59, 0.95 or II OR 0.61, 95 CI0.47, 0.78 disease were less likely to receive annual mammography than women with in-situ disease. Among this cohort of older breast cancer survivors, those at highest risk for disease recurrence were least likely to undergo annual mammography.