Appendix Table 4.
Rates of recommendations for additional imaging after screening with digital mammography by risk factors*
| Age, y | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Characteristic | 40–49 | 50–59 | 60–69 | 70–79 | 80–89 | ||||||
| Women screened, n | 113,770 | 127,958 | 94,507 | 50,204 | 18,752 | ||||||
| Additional imaging recommended, n | 14,209 | 12,604 | 8,380 | 3,968 | 1,396 | ||||||
| Number per 1,000 women screened per round (95% CI) | |||||||||||
| First-degree relatives with breast cancer |
None | 122.1 (107.7, 138.1) | 0.02 | 95.2 (85.8, 105.6) | 0.003 | 86.7 (79.0, 95.1) | 0.002 | 77.5 (69.9, 85.7) | 0.02 | 71.7 (64.6, 79.5) | 0.01 |
| One or more | 145.6 (119.6, 176.2) | 117.1 (99.7, 137.0) | 98.3 (87.9, 109.8) | 86.9 (79.1, 95.4) | 86.0 (75.5, 97.7) | ||||||
| Breast density | Fat-Scattered | 110.8 (97.9, 125.2) | 0.001 | 84.4 (74.8, 95.1) | <0.001 | 81.0 (73.1, 89.6) | <0.001 | 75.6 (68.5, 83.4) | 0.003 | 68.9 (61.7, 76.9) | 0.002 |
| Heterogeneous | 146.0 (123.9, 171.3) | 121.6 (105.8, 139.3) | 110.6 (99.7, 122.6) | 99.0 (87.9, 111.4) | 93.6 (82.4, 106.2) | ||||||
| Extreme | 116.5 (98.4, 137.4) | 98.4 (83.1, 116.2) | 81.0 (70.3, 93.2) | 63.3 (49.7, 80.1) | 92.0 (66.6, 125.7) | ||||||
| Benign breast biopsy | None | 117.8 (103.4, 134.0) | 0.001 | 90.9 (81.7, 101.0) | <0.001 | 81.9 (74.1, 90.6) | <0.001 | 72.2 (65.1, 79.9) | <0.001 | 72.1 (64.3, 80.7) | 0.07 |
| Previous | 172.5 (145.9, 202.8) | 129.3 (112.8, 147.8) | 108.2 (98.2, 118.9) | 100.5 (90.0, 112.1) | 82.7 (72.9, 93.7) | ||||||
| Race/ethnicity | White | 131.1 (119.4, 143.8) | 0.001 | 103.2 (94.8, 112.3) | 0.01 | 92.4 (85.7, 99.4) | 0.005 | 83.3 (77.1, 90.1) | 0.004 | 78.0 (71.1, 85.5) | 0.11 |
| Black | 95.9 (85.0, 108.0) | 82.6 (68.4, 99.4) | 70.8 (59.3, 84.3) | 66.3 (59.1, 74.4) | 60.3 (49.1, 74.0) | ||||||
| Asian | 89.1 (76.0, 104.2) | 73.5 (62.1, 86.8) | 64.6 (54.0, 77.0) | 52.6 (44.9, 61.4) | 40.5 (33.4, 48.9) | ||||||
| Hispanic | 127.8 (109.2, 149.0) | 84.6 (71.9, 99.3) | 76.9 (64.1, 92.0) | 72.1 (61.6, 84.3) | 62.3 (38.7, 98.9) | ||||||
| Other | 131.6 (109.8, 157.1) | 109.8 (97.1, 123.8) | 98.8 (82.5, 117.8) | 84.7 (64.0, 111.3) | 65.2 (39.4, 106.2) | ||||||
| Menopausal status | Pre | 135.4 (117.4, 155.6) | 0.01 | 124.6 (113.6, 136.4) | <0.001 | NA | NA | NA | |||
| Peri | 109.0 (92.8, 127.7) | 101.4 (78.7, 129.8) | |||||||||
| Post | 114.2 (103.1, 126.4) | 92.7 (84.0, 102.1) | |||||||||
| Menopausal hormone therapy |
None | 127.0 (111.2, 144.8) | 0.63 | 97.0 (86.7, 108.5) | 0.28 | 83.8 (76.5, 91.7) | 0.18 | 76.5 (69.8, 83.9) | 0.01 | 71.5 (64.2, 79.6) | 0.20 |
| Combination | 125.8 (83.6, 185.0) | 137.4 (105.5, 177.1) | 129.5 (96.3, 172.0) | 120.7 (94.9, 152.4) | 106.6 (79.4, 141.6) | ||||||
| Estrogen only | 110.1 (85.6, 140.7) | 105.4 (90.9, 121.8) | 106.1 (86.0, 130.3) | 125.1 (106.4, 146.6) | 106.4 (82.6, 136.1) | ||||||
| Oral contraceptives | No current | 126.6 (110.9, 144.2) | 0.05 | 99.0 (88.3, 110.7) | 0.85 | NA | NA | NA | |||
| Current use | 110.4 (90.9, 133.6) | 100.3 (84.4, 118.9) | |||||||||
| Body mass index, kg/m2 |
<25 | 133.9 (118.1, 151.3) | 0.006 | 105.9 (95.6, 117.2) | 0.05 | 93.4 (85.4, 102.1) | 0.31 | 79.5 (70.5, 89.5) | 0.28 | 83.4 (69.8, 99.5) | 0.20 |
| 25 to <30 | 129.2 (114.7, 145.2) | 99.3 (90.4, 108.9) | 88.7 (79.1, 99.4) | 84.1 (75.5, 93.6) | 69.5 (58.5, 82.3) | ||||||
| ≥30 | 110.7 (99.4, 123.2) | 93.1 (84.2, 102.8) | 89.2 (82.1, 96.8) | 89.3 (78.5, 101.5) | 88.4 (71.5, 108.8) | ||||||
*
2-sided P-values and 95% confidence intervals from a logistic regression model that accounts for clustering by radiology facility using generalized estimating equations.
†
Categories include: almost entirely fat=fat; scattered fibroglandular densities=scattered; heterogeneously dense=heterogeneous; and extremely dense=extreme.
Abbreviations: kg=kilogram; m=meter; NA=not applicable; peri=perimenopausal; pre=premenopausal; post=postmenopausal.