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- W3136353244 abstract "<h2>Abstract</h2><h3>Purpose</h3> Guidelines on mammographic surveillance after breast cancer treatment have been disseminated internationally and incorporated into Choosing Wisely recommendations to reduce low-value care. However, adherence within different countries before their publication is unknown. <h3>Methods and Materials</h3> Low-value mammography, defined as short-interval (within 6 months of radiation) or high-frequency (>1 within 12 months of radiation), was compared in Medicare fee-for-service in the United States and Ontario, Canada. Women ≥65 years diagnosed with breast cancer who underwent breast-conserving therapy with a minimum of 24 months of follow-up were included (n = 19,715 United States; 6479 Ontario). Secondary outcomes were patient and physician characteristics associated with discordance. <h3>Results</h3> Short-interval mammography was higher in the United States than in Ontario (55.9% vs 38.0%, <i>P</i> < .001), as was high-frequency (39.6% vs 7.9%, <i>P</i> < .001). In Ontario, younger age (42% ≥85 vs 58% <74 years, <i>P</i> < .001) and chemotherapy (69% vs 51%, <i>P</i> < .001) were associated with short-interval mammography; in the United States, age, earlier diagnosis year, stage, chemotherapy, rurality, and academic center treatment were associated with greater use. Chemotherapy was associated with high-frequency mammography in both countries (13% vs 7% in Ontario, <i>P</i> < .001; 69% vs 51% in United States, <i>P</i> = .02); younger age, earlier diagnosis year, stage, and nonacademic center treatment were associated in the United States. In both countries, radiation oncologists had the highest proportion of providers ordering low-value mammograms. <h3>Conclusions</h3> Despite significant evidence guiding surveillance mammography recommendations, there are high rates of short-interval mammography in both the United States and Ontario, and high rates of high-frequency mammography in the United States. Further international efforts, such as Choosing Wisely, are needed to reduce low-value mammography." @default.
- W3136353244 created "2021-03-29" @default.
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- W3136353244 date "2021-03-01" @default.
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- W3136353244 title "Mammographic Surveillance in Older Women With Breast Cancer in Canada and the United States: Are We Choosing Wisely?" @default.
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- W3136353244 doi "https://doi.org/10.1016/j.prro.2021.03.003" @default.
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