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Related Experiment Videos

Diagnostic testing following screening mammography in the elderly

H G Welch1, E S Fisher

  • 1Department of Veterans Affairs Medical Center, White River Junction, VT, USA.

Journal of the National Cancer Institute
|September 25, 1998
PubMed
Summary

Diagnostic mammograms are common after screening mammography, but additional testing is not a strong indicator of cancer. This study analyzed Medicare data to understand follow-up testing frequency and timing.

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Area of Science:

  • Radiology
  • Oncology
  • Public Health

Background:

  • Screening mammography is a key tool for early breast cancer detection.
  • Understanding the frequency and timing of follow-up diagnostic testing is crucial for evaluating screening program effectiveness.

Purpose of the Study:

  • To determine the frequency and timing of diagnostic testing after screening mammography in the US Medicare population.
  • To estimate the positive predictive value of screening mammography.

Main Methods:

  • Utilized Medicare's National Claims History System to identify a cohort of women aged 65+ screened between January and April 1995.
  • Tracked women for 8 months post-screening for additional breast imaging and biopsy procedures.
  • Defined newly detected breast cancer using claims data to estimate positive predictive value.

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Main Results:

  • Approximately 85 out of 1000 women aged 65-69 underwent follow-up testing, including imaging and biopsy.
  • Similar rates were observed for women aged 70 and older.
  • The positive predictive value of an abnormal screening mammogram was low (0.08-0.14), indicating additional testing is often not cancer-related.

Conclusions:

  • Additional diagnostic testing is a frequent outcome of screening mammography.
  • The process of follow-up testing can be lengthy.
  • The need for further testing following screening mammography has a low predictive value for cancer detection.