(ChemotherapyAdvisor) – Younger age, recent surgery, and upper extremity lymphedema were all predictive of women with breast cancer who were less likely to undergo repeated mammograms, a prospective study in the Journal of Clinical Oncology published online February 13 reported.

They surveyed 204 breast cancer survivors undergoing surveillance mammography and assessed adherence in the following year; 173 (84.8%) returned for a subsequent mammogram.

While pain from the mammography itself was not associated with adherence — moderate to high levels of pain (≥5 on a scale of 0 to 10) were reported by 40% — higher levels of mammography-related anxiety and catastrophic thoughts about mammography pain were significantly associated with not returning for a mammogram.

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“It may be important for health professionals to remind selected patients directly that some women avoid repeat mammography and to re-emphasize the value of mammography for women with a history of breast cancer,” the authors wrote. Women may also be taught behavioral techniques or prescribed medication to reduce anxiety in those with “high levels of anxiety or catastrophic thoughts related to mammography.”