Predicting reattendance at a high-risk breast cancer clinic

Palliat Support Care. 2015 Oct;13(5):1441-8. doi: 10.1017/S1478951515000164. Epub 2015 Mar 5.

Abstract

Objective: The research about follow-up patterns of women attending high-risk breast-cancer clinics is sparse. This study sought to profile daughters of breast-cancer patients who are likely to return versus those unlikely to return for follow-up care in a high-risk clinic.

Method: Our investigation included 131 patients attending the UCLA Revlon Breast Center High Risk Clinic. Predictor variables included age, computed breast-cancer risk, participants' perceived personal risk, clinically significant depressive symptomatology (CES-D score ≥ 16), current level of anxiety (State-Trait Anxiety Inventory), and survival status of participants' mothers (survived or passed away from breast cancer).

Results: A greater likelihood of reattendance was associated with older age (adjusted odds ratio [AOR] = 1.07, p = 0.004), computed breast-cancer risk (AOR = 1.10, p = 0.017), absence of depressive symptomatology (AOR = 0.25, p = 0.009), past psychiatric diagnosis (AOR = 3.14, p = 0.029), and maternal loss to breast cancer (AOR = 2.59, p = 0.034). Also, an interaction was found between mother's survival and perceived risk (p = 0.019), such that reattendance was associated with higher perceived risk among participants whose mothers survived (AOR = 1.04, p = 0.002), but not those whose mothers died (AOR = 0.99, p = 0.685). Furthermore, a nonlinear inverted "U" relationship was observed between state anxiety and reattendance (p = 0.037); participants with moderate anxiety were more likely to reattend than those with low or high anxiety levels.

Significance of results: Demographic, medical, and psychosocial factors were found to be independently associated with reattendance to a high-risk breast-cancer clinic. Explication of the profiles of women who may or may not reattend may serve to inform the development and implementation of interventions to increase the likelihood of follow-up care.

Keywords: Breast neoplasms; Early detection of cancer; Genetic predisposition to disease; Mother–child relationship; Patient compliance.

MeSH terms

  • Adult
  • Adult Children / psychology
  • Age Distribution
  • Anxiety / diagnosis
  • Anxiety / psychology
  • Breast Neoplasms / genetics
  • Breast Neoplasms / prevention & control
  • Breast Neoplasms / psychology*
  • Early Detection of Cancer / psychology
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • Forecasting
  • Genetic Predisposition to Disease / psychology*
  • Humans
  • Logistic Models
  • Los Angeles
  • Mental Health
  • Mother-Child Relations / psychology
  • Mothers
  • Patient Acceptance of Health Care / psychology*
  • Risk Assessment