Implementation of a direct patient callback system improves compliance for additional breast imaging and early breast cancer detection

Abstract

6073 Background: Existing patient recall systems usually involve contacting the referring physician who then notifies the patient to schedule a return visit for further imaging. We set out to determine whether a direct patient callback system would improve patient compliance in returning for additional imaging including magnification, spot compression, and ultrasound, and whether that would translate to an improvement in early breast cancer detection. Methods: Beginning on 4/1/2004, we prospectively identified all patients whose screening mammograms were read as having an incomplete assessment that required additional imaging (ACR BIRADS 0). Those patients were contacted directly via telephone to return for additional views. Results: Between 11/1/2002 and 3/31/3004, 1142 patients with incomplete screening mammography were identified and the referring physicians were contacted. 956 of 1142 (84%) patients returned and underwent additional breast imaging. Between 4/1/2004 and 12/31/2005, 1,336 patients with incomplete screening mammography were contacted directly to return for additional imaging. 1,307 of 1,336 (98%) patients returned and underwent additional breast imaging. (p < 0.0001, Fisher’s exact test). 125 of the 1,307 (8.5%) of the subsequent exams were found to be suspicious and biopsy was recommended (ACR BIRADS 4 or 5). Conclusions: Our new system of contacting patients with incomplete mammography has significantly increased our recall rate. Implementation of this system has enabled us to identify those patients whose mammograms are suspicious and ultimately diagnose breast cancer earlier. Direct patient callback has become standard policy and we are recommending this system for all radiology recall examinations. No significant financial relationships to disclose.