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Current Oncology
Volume 25
Issue 2
10.3747/co.25.3838
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Factors Associated with Imaging in Patients with Early Breast Cancer After Initial Treatment

by
K. Enright
1,*,
T. Desai
2,
R. Sutradhar
2,3,
A. Gonzalez
3,
M. Powis
4,
N. Taback
2,
C.M. Booth
5,
M.E. Trudeau
6 and
M.K. Krzyzanowska
3,4
1
Trillium Hlth Partners Credit Valley Hosp, Carlo Fidani Reg Canc Ctr, Mississauga, ON, Canada
2
Univ Toronto, Toronto, ON, Canada
3
Inst Clin Evaluat Sci, Toronto, ON, Canada
4
Princess Margaret Canc Ctr, Div Med Oncol & Hematol, Toronto, ON, Canada
5
Queens Univ, Canc Res Inst, Div Canc Care & Epidemiol, Kingston, ON, Canada
6
Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2018, 25(2), 126-132; https://doi.org/10.3747/co.25.3838
Submission received: 3 January 2018 / Revised: 8 February 2018 / Accepted: 8 March 2018 / Published: 1 April 2018

Abstract

Background: Overuse of surveillance imaging in patients after curative treatment for early breast cancer (EBC) was recently identified as one of the Choosing Wisely Canada initiatives to improve the quality of cancer care. We undertook a population-level examination of imaging practices in Ontario as they existed before the launch of that initiative. Methods: Patients diagnosed with ebc between 2006 and 2010 in Ontario were identified from the Ontario Cancer Registry. Records were linked deterministically to provincial health care databases to obtain comprehensive follow-up. We identified all advanced imaging exams [aies: computed tomography (CT), bone scan, positron-emission tomography] and basic imaging exams (bies: ultrasonography, chest radiography) occurring within the first 2 years after curative treatment. Poisson regression was used to assess associations between patient or provider characteristics and the rate of AIES. Results: Of 30,006 women with ebc, 58.6% received at least 1 BIE, and 30.6% received at least 1 AIE in year 1 after treatment. In year 2, 52.7% received at least 1 BIE, and 25.7% received at least 1 AIE. The most common AIES were chest CTS and bone scans. The rate of AIES increased with older age, higher disease stage, comorbidity, chemotherapy exposure, and prior staging investigations (p < 0.001). Imaging was ordered mainly by medical oncologists (38%), followed by primary care physicians (23%), surgeons (13%), and emergency room physicians (7%). Conclusions: Despite recommendations against its use, imaging is common in EBC survivors. Understanding the factors associated with aie use helps to identify areas for further research and is required to lower imaging rates and to improve survivorship care.
Keywords: early breast cancer; imaging overuse; curative treatment early breast cancer; imaging overuse; curative treatment

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MDPI and ACS Style

Enright, K.; Desai, T.; Sutradhar, R.; Gonzalez, A.; Powis, M.; Taback, N.; Booth, C.M.; Trudeau, M.E.; Krzyzanowska, M.K. Factors Associated with Imaging in Patients with Early Breast Cancer After Initial Treatment. Curr. Oncol. 2018, 25, 126-132. https://doi.org/10.3747/co.25.3838

AMA Style

Enright K, Desai T, Sutradhar R, Gonzalez A, Powis M, Taback N, Booth CM, Trudeau ME, Krzyzanowska MK. Factors Associated with Imaging in Patients with Early Breast Cancer After Initial Treatment. Current Oncology. 2018; 25(2):126-132. https://doi.org/10.3747/co.25.3838

Chicago/Turabian Style

Enright, K., T. Desai, R. Sutradhar, A. Gonzalez, M. Powis, N. Taback, C.M. Booth, M.E. Trudeau, and M.K. Krzyzanowska. 2018. "Factors Associated with Imaging in Patients with Early Breast Cancer After Initial Treatment" Current Oncology 25, no. 2: 126-132. https://doi.org/10.3747/co.25.3838

APA Style

Enright, K., Desai, T., Sutradhar, R., Gonzalez, A., Powis, M., Taback, N., Booth, C. M., Trudeau, M. E., & Krzyzanowska, M. K. (2018). Factors Associated with Imaging in Patients with Early Breast Cancer After Initial Treatment. Current Oncology, 25(2), 126-132. https://doi.org/10.3747/co.25.3838

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