Clinical outcomes of mammography in the National Breast and XXXX Early Detection Program, 2009-2012.

@entity5 @entity1
PURPOSE: The National Breast and @entity5 Early Detection Program (NBCCEDP) enrolls asymptomatic @entity1 for @entity5 screening and symptomatic @entity1 for diagnostic services. This study describes the results of mammograms provided by the NBCCEDP, by examination indication (screening or diagnostic), and by age group. METHODS: For the first NBCCEDP-funded mammogram received during 2009-2012, we calculated age-specific percentages of abnormal findings, rates of follow-up testing, and invasive and in situ breast @entity5 diagnoses per 1,000  mammograms. Logistic regression was used to estimate the odds for each of these outcomes by examination indication. RESULTS: The NBCCEDP provided 941,649 screening, 175,310 diagnostic, and 30,434 unknown indication mammograms to 1,147,393 @entity1 . The percentage with abnormal mammograms was higher for diagnostic mammograms (40.1  %) than for screening mammograms (15.5  %). Compared with @entity1 aged 40-49  years, fewer @entity1 aged 50-64  years had abnormal results for screening (13.7 vs. 19.7  %) and diagnostic mammograms (37.7 vs. 42.7  %). Follow-up rates per 1,000  mammograms were lower among @entity1 aged 50-64 compared to those aged 40-49 (screening: 143.9 vs. 207.5; diagnostic: 645.3 vs. 760.9); biopsy rates exhibited a similar pattern (screening: 24.1 vs. 32.9; diagnostic: 167.7 vs. 169.7). For screening mammograms, older @entity1 had more @entity5 detected than younger @entity1 (invasive: 3.6 vs. 2.2; in situ: 2.3 vs. 2.0). Similarly, for diagnostic mammograms, @entity5 detection was higher for older @entity1 (invasive: 67.8 vs. 36.6; in situ: 17.4 vs. 11.1). CONCLUSIONS: Abnormal mammograms and diagnostic follow-up procedures were less frequent in @entity1 aged 50-64  years compared to @entity1 aged 40-49  years, while breast @entity5 detection was higher, regardless of indication for the mammogram. Some of these differences between age groups were greater for screening mammograms than for diagnostic mammograms. @entity5 detection rates were higher for diagnostic mammograms compared with screening mammograms. These findings support the NBCCEDP's priority of serving @entity1 aged 50-64  years and providing both screening and diagnostic mammograms.
