Inpatient mammography feasible for women late for screening


Researchers led by Dr. Waseem Khaliq of Johns Hopkins University School of Medicine have found that the combination of inpatient breast cancer screening training and inpatient screening mammography made it possible to obtain a screening mammogram for hospitalized women. They also found that more African American hospitalized women (86.2%) had had a hospital-based screening mammogram than white patients (75.4%).

“The finding is relevant because women with limited access to health care are disproportionately racial minorities and are more likely to be diagnosed with advanced cancer than their Caucasian counterparts,” the authors wrote. ‘study.

About 40% of hospitalized women aged 50 to 75 are late or do not adhere to breast cancer screening guidelines, and nearly a third of this group are also at high risk of developing breast cancer. Although the incidence of breast cancer is higher in white women, African American women have a higher death rate than white women, according to previous research. In terms of screening mammography traditionally performed on an outpatient basis, the most common obstacles are transportation and not forgetting to make an appointment.

In their study, the researchers wanted to see if it was possible to coordinate inpatient screening mammograms for these women before they were discharged from the hospital. The team looked at data from 101 uninsured women aged 50 to 74 who were hospitalized in a general practice ward, 29% of whom were African-American.

Information such as socio-demographic background, reproductive history, family history of breast cancer and medical co-morbidities were collected from January 2015 to October 2016. Data was analyzed in March 2018.

Of the women, 22 were unable to receive a hospital-based screening mammogram, although they agreed to be screened. This is mainly due to the fact that these women were discharged from the hospital before the test, changed their minds, or their clinical condition worsened during hospitalization, requiring transfer to a level of superior care.

The remaining 79 women underwent in-hospital screening mammograms, all of whom were “extremely satisfied” with the experience, the team said.

“The convenience of having a screening mammogram while in hospital has been reported as a major factor in late screening completion,” the authors wrote.

The average time for the mammogram procedure was 28 minutes, and the time required to get finalized reports was 5 hours and 16 minutes. About 95% of women who were screened received their mammogram report before discharge and the results were explained to them.

Of the 27 women requiring additional imaging, 17 received it during hospitalization, while the remaining 10 were referred and recommended for outpatient follow-up. No cases of breast cancer were found among the initial screening tests. Follow-up tests were done while the patients were in the hospital.

All nurses caring for these women have said that this practice should be part of the standard of care. About 66% of hospital doctors agreed that this practice is feasible, according to the researchers.

“If this practice were adopted widely, it would improve adherence to breast cancer screening guidelines, especially in a higher risk cohort of patients than in the general population,” the authors wrote.

However, the team noted that it remains to be seen whether health insurance will cover the cost of such screening for hospital patients.

“As hospitals move towards assimilation into accountable healthcare organizations with high-level electronic medical records, the tests necessary for preventive care should be made available to patients where and when they interact with the healthcare system.” , the group said.

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