Impact of Telephone Communication on Patient Adherence With Follow-Up Recommendations After an Abnormal Screening Mammogram

Objective: The Mammography Quality Standards Act requires written communication to every patient after an abnormal screening mammogram. Starting in 2013, our institution began telephoning all patients with a Breast Imaging Reporting and Data System (BI-RADS) assessment 0 on the next business day to schedule their diagnostic follow-up. Our aim is to analyze the changes in adherence and time to follow-up of patients recalled from screening mammography after the implementation of telephone communication. Methods: This retrospective study reviewed data from screening mammograms at our institution with a BI-RADS 0 assessment excluding technical recalls between January 1, and December 31, 2011 (pre-intervention group), 2014 (early post-intervention group), and 2018 (later post-intervention group). We compared patient adherence with timely follow-up diagnostic mammography (within 60 days) in these three groups using univariate and multivariate logistic regression. Cox proportional hazards regression analysis was done to evaluate the impact of telephone communication on time to follow-up. Results: This study included 1899 women in 2011, 2829 women in 2014, and 1999 women in 2018. We found that 73.1% patients in 2011 returned for their diagnostic follow-up within 60 days compared to 87.6% in 2014 and 90.0% in 2018, P < 0.001. Median time to follow-up in 2011 was 28 days (IQR 17-76 days) compared to 15 days (IQR 9-28 days) in 2014 and 9 days (IQR 5-18) in 2018, P < 0.001. Conclusion: A higher percentage of women were adherent with a timely diagnostic follow-up examination after an abnormal screening mammogram with the addition of telephone communication.