Abstract 21372: Women Undergoing Coronary Artery Bypass Graft Surgery Do Not Follow Any Recommended Guidelines for Breast Cancer Screening

Introduction: In the United States, 1 in 4 women dies of heart disease. Severe coronary artery disease is usually treated with coronary artery bypass graft (CABG) surgery to prolong a patient’s life span. To maintain the significant survival benefit derived from this procedure, vigilant post-care counseling is performed to prevent further health complications. Current post-CABG care guidelines include counseling on exercise, diet, and medical management but do not explicitly contain recommendations for other primary preventative care. Screening mammography (SM) for primary prevention is an effective measure that reduces women's mortality due to breast cancer by ~30%. Hypothesis: We hypothesize that women change the frequency of screening mammography following CABG surgery. Methods and Results: Using electronic medical record data, we identified a retrospective cohort of 170 women who underwent CABG surgery and SMs between 2002-2012. Recommended guidelines during these years varied between 0.5-1 SM per year (SM/year). The rate of SM/year prior to- and following CABG were calculated. We performed the same analysis on a second cohort of 400 women who underwent a cardiac catheterization (Cath) during the same time period and were found to have preserved heart function without CAD as a control group. The mean (95% CI) age of the CABG women at first screening mammogram, CABG procedure and last follow-up was, respectively, 61 (60-63), 67 (65-68), and 73 (71-74). The median SM/year before CABG procedure was 0.51 compared to 0.28 following CABG procedure (p<0.0001). The median SM/year for Cath women ranged from 0.64 to 0.45 following Cath procedure. Conclusion: Women following CABG have the lowest breast cancer screening rates and are not meeting any recommended screening guidelines for mammography. These results indicate that further study of patient, provider, and/or system-related factors resulting in this change of preventative care is warranted.