Utilization of Mammography Prior to Elective Breast Surgery: A National Claims-Based Analysis
Erika D. Sears, MD, MS1, Yu-Ting Lu, MPH1, Peter R. Swiatek, BA1, Ting-Ting Chung, MS2, Kevin C. Chung, MD, MS1.
1University of Michigan, Ann Arbor, MI, USA, 2Chang-Gung Memorial Hospital, Taoyuan, Taiwan.
PURPOSE: To measure preoperative mammography use in patients evaluated for symptomatic macromastia, and assess the impact of preoperative mammography on future diagnostic testing and new diagnoses of breast disease, particularly among patients in low-risk age groups.
METHODS: We analyzed the Truven MarketScan Databases from 2009-2015 to identify female patients age 18 years and older diagnosed with macromastia. A subgroup of patients was identified who underwent screening and/or diagnostic mammography within 12 months of the initial macromastia evaluation. We recorded additional procedures performed (MRI, ultrasound, and biopsy) and new diagnoses of benign or malignant breast disease within 3 months after mammography. Age-specific rates of mammography use were compared between the macromastia and general population cohorts.
RESULTS: We identified 52,486 patients diagnosed with macromastia, of which 59.6% underwent mammography. Macromastia patients 39 years and younger had a higher rate of mammography use (18.4%) compared to general population (2.8%) (P<0.001). Among the macromastia patients age 39 years and younger who received mammography, 16.2% received at least one additional procedure (MRI, US, or biopsy), 8.3% underwent biopsy, and only 0.46% (n=17) were diagnosed with malignant breast disease within 3 months after mammography (Table).
CONCLUSION: Providers must realize the impact of mammography use in young patients of average risk for breast cancer as it translates to a real risk of additional studies and invasive procedures.
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