Factors Associated With Optimal Follow-up in Women With BI-RADS 3 Breast Findings.
Factors Associated With Optimal Follow-up in Women With BI-RADS 3 Breast Findings.
复制标题
DOI：
10.1016/j.jacr.2019.10.003
复制
发表时间：
2020-04
期刊：
影响因子：
--
通讯作者：
Khorasani R
中科院分区：
文献类型：
--
作者：
Lacson R;Wang A;Cochon L;Giess C;Desai S;Eappen S;Khorasani R
评估BI-RADS 3型乳腺发现患者最佳随访率及相关因素。这项经机构审查委员会批准的回顾性队列研究在一家学术医疗中心进行，包括2016年接受乳房成像（超声和乳房x光检查）的所有女性。具有BI-RADS 3评估的独特患者的指数报告（通过自然语言处理检索）包括研究人群。从研究数据仓库中提取患者特定和提供者相关的特征。机构癌症登记处确定了被诊断患有乳腺癌的患者。最佳随访率计算为BI-RADS 3级评估患者在指数检查后3 - 9个月对同一乳房进行随访影像学检查的患者。单变量分析和多变量逻辑回归确定了与最佳随访相关的特征。记录肿瘤的恶性率和到恶性检测的时间。在93,685例乳腺影像学检查中，64,771例来自特殊患者，其中2,967例有BI-RADS 3发现（4.6%）。排除非现场指标检查患者和距指标检查时间<3个月的患者，1511例患者中有1125例（74%）获得最佳随访。在单变量和多变量分析中，既往乳腺癌与最佳随访相关；年龄较小，西班牙裔，离婚状况，缺乏保险，没有最佳随访。恶性肿瘤率= 0.86%;平均检测时间=330天。只有74%的女性BI-RADS 3乳腺影像学随访结果是最佳的。进一步促进随访的干预措施应针对年轻、未婚妇女、西班牙裔妇女、无乳腺癌病史和无保险的妇女。在这项研究中，在一个每年进行超过90,000次乳房检查的大型卫生系统中，只有74%的女性在乳房指数检查中被评估为BI-RADS 3，并按照建议进行了最佳随访。
Assess rate of and factors associated with optimal follow-up in patients with BI-RADS 3 breast findings. 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 3–9 months from the index exam 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 was recorded. Among 93,685 breast imaging exams, 64,771 were from unique patients of which 2,967 had BI-RADS 3 findings (4.6%). Excluding patients with off-site index exams and those with another breast exam <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 with not having optimal follow-up. Malignancy rate=0.86%; mean time to detection=330 days. 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. In this study at a large health system conducting over 90,000 breast examinations annually, only 74% of women assessed to have BI-RADS 3 on an index breast examination had optimal follow-up as recommended.
登录
查看更多内容
影响因子：
5.1
作者：
Greiner, KA;Engelman, KK;Ellerbeck, EF
通讯作者：
Ellerbeck, EF
影响因子：
3
作者：
Sabatino, Susan A.;Coates, Ralph J.;Shaw, Kate M.
通讯作者：
Shaw, Kate M.
影响因子：
2.5
作者：
Flieger, Signe Peterson;Thomas, Cindy Parks;Prottas, Jeffrey
通讯作者：
Prottas, Jeffrey
影响因子：
3.5
作者：
Hysong SJ;Sawhney MK;Wilson L;Sittig DF;Esquivel A;Singh S;Singh H
通讯作者：
Singh H
DOI：
10.1001/jama.2015.12783
发表时间：
2015-10-20
期刊：
JAMA
影响因子：
--
作者：
Oeffinger KC;Fontham ET;Etzioni R;Herzig A;Michaelson JS;Shih YC;Walter LC;Church TR;Flowers CR;LaMonte SJ;Wolf AM;DeSantis C;Lortet-Tieulent J;Andrews K;Manassaram-Baptiste D;Saslow D;Smith RA;Brawley OW;Wender R;American Cancer Society
通讯作者：
American Cancer Society