Women diagnosed with breast cancer are increasingly burdened by multiple imaging appointments prior to surgery, according to researchers from Fox Chase Cancer Center in Philadelphia, who presented the findings Dec. 9 at the San Antonio Breast Cancer Symposium.
More patients have repeat visits for imaging than they did 20 years ago, and single imaging appointments increasingly include multiple types of imaging, according Richard Bleicher, MD, surgical oncologist at Fox Chase, and colleagues.
The researchers found that between 1992 and 2005, the percentage of patients who had two or more imaging visits nearly quadrupled. Additional visits present a burden to patients, many of whom are elderly, but the stress may be alleviated through better coordination and evaluation by physicians, Bleicher said in a statement.
"The burden to the patient is increasing substantially," Bleicher said. "The number of days patients are having mammograms, MRIs and ultrasounds is going up steadily year by year. They're having imaging done more frequently on separate dates during the preoperative interval than ever before."
The researchers evaluated Medicare claims linked to Surveillance Epidemiology and End Results data for women developing breast cancer between 1992 and 2005 and analyzed visits for 67,751 women older than age 65 who had invasive, nonmetastatic breast cancer and simultaneous breast surgery with lymph node staging.
The researchers found that in 1992, roughly one in 20 of these cancer patients underwent imaging twice or more during the preoperative interval. By 2005, that portion had climbed to about one in five.
Bleicher and colleagues also found that a single imaging visit increasingly included multiple imaging types. In 1992, 4.3 percent of patients underwent multiple types of imaging; in 2005, that rate rose to 27.1 percent.
With the increased use of imaging, Bleicher said that for physicians, "the question becomes, 'How are we affecting patients overall with what we're ordering nowadays?' ... I wanted to take a look at how things have been changing for patients and how many times they have to travel back and forth to get more imaging."
Bleicher continued, "Physicians need to keep in mind that it's hard enough for working people to take off from work and trek back and forth to appointments, but older people have infirmities, and it's harder to get around. The coordination of care is very important. We need to focus more on the burden to the patient."
The researchers are now diving deeper into their data to understand the trend and look for a better way to help breast cancer patients with imaging. "We want to see whether or not there is a more efficient method of imaging the patients so that we're improving outcomes without increasing costs."