UCSF Study Finds Breast Imaging Follow-Up Varies Across the Country

A new study by researchers at UC San Francisco looked at follow-up imaging for women with non-metastatic breast cancer across the country. With high health care costs, patients often have to pay for medical expenses out of pocket. Also, since these patients already have cancer, radiologists do not want to induce another cancer with radiation from unnecessary imaging.

Data from 36,045 women ages 18-64 were examined over an 18-month period. Researchers found wide, unexplained variations in their follow-up care. Many patients did not receive recommended follow-ups while others received unnecessary full-body imaging.

Such variations suggest that many doctors are not following treatment guidelines from the American Society of Clinical Oncology and the National Comprehensive Cancer Network, both of which recommend that women with non-metastatic breast cancer receive annual physical exams and mammograms, but not full-body imaging using computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), or bone scans.

“Age and therapy make sense as predictors of breast imaging, but it doesn’t make sense that where you live makes a difference in whether you were likely to get a follow-up mammogram or high-cost imaging,” says Ben Franc, MD, professor of clinical radiology in the nuclear medicine subspecialty at UCSF’s Department of Radiology and Biomedical Imaging. “What’s actionable here is that we have these guidelines, but doctors aren’t following them.”

The study itself was published on July 13, 2016, in JNCCN: Journal of the National Comprehensive Cancer Network. Other UCSF authors include R. Adams Dudley, MD, MBA; Timothy Copeland, MPP;  Robert Thombley, BS; Miran Park, PhD; Ben Marafino, BSc; Mitzi Dean, MHA, MS, and W. John Boscardin, PhD. They were joined by David Seidenwurm, MD, of the Sutter Medical Group; and Bhupinder Sharma, FRCP, and Stephen R.D. Johnston, MA, FRCP, PhD, both of The Royal Marsden NHS Foundation Trust, UK. 

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