Disease-Specific Barriers to Breast Cancer Screening Guideline Adherence among Hidradenitis Suppurativa Patients

Document Type

Conference Proceeding

Publication Date

7-8-2025

Publication Title

Ann Surg Oncol

Keywords

adult, aged, anxiety, breast cancer, cancer epidemiology, cancer screening, cancer survivor, cohort analysis, conference abstract, controlled study, diagnosis, face disorder, family history, female, health care access, human, major clinical study, mammography, medicaid, medical record review, practice guideline, protocol compliance, retrospective study, severity of illness index, suppurative hidradenitis, surgery, university hospital

Abstract

Background/Objective: The American Cancer Society recommends annual breast cancer screening with mammography starting at age 40-45. Previous studies have found that patients with hidradenitis suppurativa (HS) affecting the breasts are less likely to breastfeed. Furthermore, mammography painrelated anxiety has been associated with decreased surveillance adherence among breast cancer survivors. As such, patients with HS affecting the breasts may also face disease-specific barriers to adhering to mammography guidelines. This study aims to assess the adherence to breast cancer screening guidelines among HS patients and to define any disease-specific barriers such as breast involvement on this adherence. Methods: A retrospective chart review cohort study was conducted in the Dermatology department of an academic medical center from 2019-2024 on female patients with HS who were seen in clinic; mammography records were assessed between 2015-2024. Statistical analysis was performed using Multivariate Poisson regression. Results: 669 patients were followed for a median of 9.1 (interquartile range 5.3-11.1) years. Median adherence to annual surveillance was 32% (interquartile range 0-60%), with 64% of patients receiving any screening. Hurley Stage 3 (rate ratio [95% CI]: 0.88 [0.77-0.99] vs Stage 1) and Medicaid insurance (0.82 [0.70-0.98] vs commercial insurance) were associated with decreased frequency of screenings. HS involvement of the breasts, Hurley stage of the breasts, age, race, and personal or family history of breast cancer were not significantly associated. Conclusions: Patients with HS face disease-specific barriers to adherence to breast cancer surveillance guidelines in real-world practice. These barriers include disease severity and insurance type, highlighting disparities in healthcare access within this patient population. However, HS involvement of the breasts did not result in differences in adherence. This study suggests that HS results in overall disease-specific barriers limiting access to breast cancer screening beyond breast involvement.

Volume

32

Issue

2

First Page

S831

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