Impact of mammography and breast ultrasound on health outcome among young breast cancer survivors: A retrospective cohort study

Background: As the increasing number of cancer survivors, survivorship care is recommended for those who have completed primary treatment. But little is known about the influence of survivorship care on health outcome, especially among younger survivors. The objective of this study was to explore the association of mammography and breast ultrasound on the mortality and recurrence of young breast cancer survivors. Method: A retrospective cohort study was conducted between 2004 and 2010. Stage I-III breast cancer survivors younger than 50 year-old, diagnosed from 2004 to 2007 were included (n=9847). Using the national health insurance database, cancer registry data and death registry data, we examined the use of mammography and breast ultrasound in the survivorship year 1 and the health outcome of survivors. Data was analyzed using Cox proportional-hazards regression model, controlling for the characteristics of patients and healthcare providers. Result: A significant increasing trend (p< .0001) in the use of mammography or breast ultrasound was observed during the study period. Multivariate analysis revealed that the use of mammography is significantly associated with recurrence (HR=0.64, CI: 0.51-0.80) and mortality (HR=0.41, CI: 0.32-0.53); the use of breast ultrasound is also significantly associated with recurrence (HR=0.65, CI: 0.51-0.81) and mortality (HR=0.74, CI: 0.59-0.93). Young breast cancer survivors using both mammography and breast ultrasound have less mortality (HR=0.45, CI: 0.37-0.55) and less risk of recurrence (HR=0.61, CI: 0.50-0.74). Conclusion Mammography and breast ultrasound are valuable tools for young breast cancer survivors and is probably beneficial to improve survival and to reduce the recurrence risk.