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Predicting reattendance at a high-risk breast cancer clinic

Published online by Cambridge University Press:  05 March 2015

Sarah R. Ormseth Open the ORCID record for Sarah R. Ormseth [Opens in a new window] ,
David K. Wellisch ,
Adam E. Aréchiga  and
Taylor L. Draper
Sarah R. Ormseth
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California
David K. Wellisch*
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California
Adam E. Aréchiga
Affiliation:
Department of Psychology, Loma Linda University, Loma Linda, California
Taylor L. Draper
Affiliation:
Department of Psychology, Loma Linda University, Loma Linda, California
*
Address correspondence and reprint requests to: David K. Wellisch, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, California 90024-1759. E-Mail: dwellisch@mednet.ucla.edu
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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 neoplasmsGenetic predisposition to diseaseMother–child relationshipEarly detection of cancerPatient compliance

Information

Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 5 , October 2015 , pp. 1441 - 1448
Copyright
Copyright © Cambridge University Press 2015 

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