Utility of mammography for chronic kidney disease patients undergoing kidney transplant evaluation

Transplant centers typically require screening mammography (MMG) for women ≥40 during evaluation. American Cancer Society recommends starting annual MMG at 40, while USPSTF recommends biennial MMG at 50. We sought to determine the effect of age and other breast malignancy risk factors on screening M...

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Bibliographic Details
Published in:Clinical transplantation 2016-04, Vol.30 (4), p.445-451
Main Authors: Stoecker, Jordan B., Cote, Devan R., Augustine, Joshua J., Sarabu, Nagaraju, Schulak, James A., Sanchez, Edmund Q., Humphreville, Vanessa R., Ammori, John B., Woodside, Kenneth J.
Format: Article
Language:English
Subjects:
Adult
Aged
Biopsy
breast cancer
Breast Neoplasms - complications
Breast Neoplasms - diagnosis
cancer screening
chronic kidney disease
end-stage renal disease
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Kidney Failure, Chronic - pathology
Kidney Failure, Chronic - surgery
Kidney Function Tests
Kidney Transplantation
mammography
Mammography - utilization
Middle Aged
Prognosis
Retrospective Studies
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Summary:Transplant centers typically require screening mammography (MMG) for women ≥40 during evaluation. American Cancer Society recommends starting annual MMG at 40, while USPSTF recommends biennial MMG at 50. We sought to determine the effect of age and other breast malignancy risk factors on screening MMG in the pre‐transplant renal failure population undergoing transplant evaluation. Methods We retrospectively examined women ≥40 undergoing kidney transplant evaluation from 2006 to 2012 (n = 541). Results Patients aged 40.0–49.9 and ≥50 had similar rates of breast biopsy and breast malignancy. African Americans underwent a higher rate of biopsies (OR 2.391, 95%CI 1.111–5.019, p = 0.026), with a lower rate of biopsy in those already on dialysis at presentation (OR 0.434, 95%CI 0.212–0.888, p = 0.022). Higher breast density (>50% fibroglandular tissue) increased both rate of biopsy (OR 2.876, 95%CI 1.377–6.010, p = 0.005) and malignancy (OR 5.061, 95%CI 1.012–25.315, p = 0.048). Conclusions As we found no independent differences in biopsy or malignancy between age groups, it is reasonable for transplant centers to use the same evaluation MMG screening policy for all women ≥40. However, as malignancy risk increased with higher breast density, a lower threshold for additional workup may be warranted in patients with dense breasts or an indeterminate lesion on MMG.
ISSN:0902-0063
1399-0012
DOI:10.1111/ctr.12709