Which groups are in danger of not receiving surveillance mammography?

This paper studied the factors associated with breast cancer survivors receiving surveillance mammography. 

Breast cancer survivors are at risk for recurrence (return of breast cancer) and a second primary breast tumour (a new cancer source in one of the breasts) . It is recommended that survivors should undergo yearly surveillance mammography. Surveillance mammography can include a mammogram (x-ray screening of the breast) or magnetic resonance imagine (MRI; uses magnetic fields to produce high-quality images of the breast) to detect cancer. This would reduce breast cancer mortality (death). However, many women do not undergo surveillance mammography.

The authors aimed to evaluate the factors that are associated with women not undergoing survaillance mammography.

4,216 women with stage I or stage II breast cancer who were recurrence-free were studied. During year 1, 79% of women received surveillance mammography. By year 6, only 68% of women received surveillance mammography. In years 7-10, 63-66% of women received surveillance. Patients received an average of 4 surveillance mammograms over the 10 years.

Women who were younger than 40 years and older than 80 were less likely to receive surveillance than those aged between 50 and 59. Smokers and women with comorbidities (other diseases) were less likely to receive mammography. Women who had a more recent diagnosis, with stage II cancer and those who received mastectomy (removal of breast) or breast-conserving surgery (removal of breast tissue) without radiation were less likely to receive surveillance.  Additionally, pre-menopausal women less than 64 years old at diagnosis were less likely to receive surveillance mammography compared to post-menopausal women of similar age. 

Women with outpatient visits to primary care providers or oncologists were more likely to undergo surveillance. 

These factors were similar among different age groups of patients.

The authors concluded that certain important groups of women are at risk for not following up with surveillance mammography, even amongst younger breast cancer survivors. It is important to actively engage breast cancer survivors in long term follow up care. 

This study involved patients with access to complete medical care, so results might be different in patients with less access to medical care. Additionally, other factors not studied here could have affected results.