Geographic Variation in Postoperative Imaging for Low-Risk Breast Cancer Article Swipe
YOU?
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· 2018
· Open Access
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· DOI: https://doi.org/10.6004/jnccn.2018.7024
Background: The objective of this study was to examine the presence and magnitude of US geographic variation in use rates of both recommended and high-cost imaging in young patients with early-stage breast cancer during the 18 month period after surgical treatment of their primary tumor. Methods: Using the Truven Health MarketScan Commercial Database, a descriptive analysis was conducted of geographic variation in annual rates of dedicated breast imaging and high-cost body imaging of 36,045 women aged 18 to 64 years treated with surgery for invasive unilateral breast cancer between 2010 and 2012. Multivariate hierarchical analysis examined the relationship between likelihood of imaging and patient characteristics, with metropolitan statistical area (MSA) serving as a random effect. Patient characteristics included age group, BRCA1/2 carrier status, family history of breast cancer, combination of breast surgery type and radiation therapy, drug therapy, and payer type. All MSAs in the United States were included, with areas outside MSAs within a given state aggregated into a single area for analytic purposes. Results: Descriptive analysis of rates of imaging use and intensity within MSA regions revealed wide geographic variation, irrespective of treatment cohort or age group. Increased probability of recommended postoperative dedicated breast imaging was primarily associated with age and treatment including both surgery and radiation therapy, followed by MSA region (odds ratio, 1.42). Increased probability of PET use-a high-cost imaging modality for which postoperative routine use is not recommended in the absence of specific clinical findings-was primarily associated with surgery type followed by MSA region (odds ratio, 1.82). Conclusions: In patients with breast cancer treated for low-risk disease, geography has effects on the rates of posttreatment imaging, suggesting that some patients are not receiving beneficial dedicated breast imaging, and high-cost nonbreast imaging may not be targeted to those groups most likely to benefit.
Related Topics
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.6004/jnccn.2018.7024
- https://jnccn.org/downloadpdf/journals/jnccn/16/7/article-p829.pdf
- OA Status
- bronze
- Cited By
- 7
- References
- 46
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2883085519
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W2883085519Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.6004/jnccn.2018.7024Digital Object Identifier
- Title
-
Geographic Variation in Postoperative Imaging for Low-Risk Breast CancerWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2018Year of publication
- Publication date
-
2018-07-01Full publication date if available
- Authors
-
Benjamin L. Franc, Timothy P. Copeland, Robert Thombley, Mi‐Ran Park, Ben J. Marafino, Mitzi L. Dean, W. John Boscardin, Hope S. Rugo, David Seidenwurm, Bhupinder Sharma, Stephen Johnston, R. Adams DudleyList of authors in order
- Landing page
-
https://doi.org/10.6004/jnccn.2018.7024Publisher landing page
- PDF URL
-
https://jnccn.org/downloadpdf/journals/jnccn/16/7/article-p829.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
bronzeOpen access status per OpenAlex
- OA URL
-
https://jnccn.org/downloadpdf/journals/jnccn/16/7/article-p829.pdfDirect OA link when available
- Concepts
-
Medicine, Breast cancer, Breast imaging, Radiation therapy, Odds ratio, Cohort, Geographic variation, Multivariate analysis, Descriptive statistics, Breast-conserving surgery, Cancer, Internal medicine, Surgery, Mammography, Mastectomy, Population, Environmental health, Statistics, MathematicsTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
7Total citation count in OpenAlex
- Citations by year (recent)
-
2024: 2, 2020: 3, 2019: 2Per-year citation counts (last 5 years)
- References (count)
-
46Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.body | 70 |
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| abstract_inverted_index.areas | 150 |
| abstract_inverted_index.given | 155 |
| abstract_inverted_index.month | 36 |
| abstract_inverted_index.payer | 139 |
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| abstract_inverted_index.type. | 140 |
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| abstract_inverted_index.which | 226 |
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| abstract_inverted_index.years | 79 |
| abstract_inverted_index.young | 27 |
| abstract_inverted_index.1.42). | 216 |
| abstract_inverted_index.1.82). | 251 |
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| abstract_inverted_index.States | 146 |
| abstract_inverted_index.Truven | 48 |
| abstract_inverted_index.United | 145 |
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| abstract_inverted_index.cancer | 32, 87, 257 |
| abstract_inverted_index.cohort | 185 |
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| abstract_inverted_index.region | 213, 248 |
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| abstract_inverted_index.carrier | 121 |
| abstract_inverted_index.effect. | 114 |
| abstract_inverted_index.effects | 264 |
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| abstract_inverted_index.including | 204 |
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| abstract_inverted_index.Commercial | 51 |
| abstract_inverted_index.MarketScan | 50 |
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| abstract_inverted_index.posttreatment | 269 |
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| institutions_distinct_count | 12 |
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