The impact of obesity on follow-up after an abnormal screening mammogram
A partir de données portant sur 201 470 participantes, cette étude évalue l'impact de l'obésité sur le suivi médical de femmes ayant eu un résultat anormal lors de leur mammographie de dépistage
Background: Effective breast cancer screening and early detection are crucial for obese women, who experience a higher incidence of the disease and present at later stages. Methods: We examined the association between body mass index (BMI) and timeliness of follow-up after 241,222 abnormal screening mammograms performed on 201,470 women in the Breast Cancer Surveillance Consortium. Each mammogram had one of three recommendations for follow-up: short-interval follow-up; immediate additional diagnostic imaging; and biopsy/surgical consultation. We used logistic regression to estimate the adjusted effect of BMI on any recorded follow-up within 270 days of the recommendation; linear regression was used to model the mean follow-up time among those with recorded follow-up. Results: As compared to normal-weight women, higher BMI was associated with slightly increased odds of follow-up among women who received a recommendation for short-interval follow-up (odds ratios (ORs) 1.03-1.10; p=0.04) or immediate additional imaging (ORs 1.03-1.09; p=0.01). No association was found for biopsy/surgical consultation recommendations (p=0.90). Among those with recorded follow-up, higher BMI was associated with longer mean time to follow-up for both short-interval (3-10 days; p<0.001) and additional imaging recommendations (2-3 days; p<0.001), but not biopsy/surgical consultation (p=0.06). Regardless of statistical significance, actual differences in days to follow-up across BMI groups were small and unlikely to be clinically significant. Conclusions: Once obese women access screening mammography, their follow-up after abnormal results is similar to that of normal-weight women. Impact: Efforts to improve early detection of breast cancer in obese women should focus elsewhere, such as improving participation in screening mammography.