Mammography is one of the most important means of breast cancer screening. Mammography detects cancer an average of 1.7 years before a woman or her clinician can manually detect it. It is estimated that 10 to 27% of the women who have an inconclusive mammogram do not return for further medical evaluation, which could possibly detect cancer at an early and possibly more treatable stage. Thus, despite the fact that early detection of breast cancer may be life-saving for some women, thousands of women who may be at risk do not follow through to receive a diagnosis. Very little is known about the characteristics of these women.

This study will seek to learn more about this understudied and often forgotten group. The purpose of this study is to examine the sociodemographic characteristics of the women who do not choose to return for evaluation after an inconclusive screening mammogram. A number of factors suggested by previous studies and clinical practice will be explored including patient satisfaction, cancer fatalism, anxiety, and demographic characteristics such as race, ethnicity, and socioeconomic status.

Cox's Interaction Model of Client Health Behavior will be used as a framework. A sample of 120 women from two university hospitals, who have been notified of their abnormal screening mammograms, will be contacted for participation in the study. Sixty women who have received diagnostic follow-up and 60 women who have not received follow-up will participate in a telephone interview to determine the differences between these two groups. A major outcome of this study is to determine those factors that place a woman at risk for not returning for diagnostic follow-up after an inconclusive screening mammogram, so that the information can be used to design an innovative and culturally sensitive intervention protocol to increase adherence to diagnostic evaluation.