Abstract PS1-04-24: Factors associated with adherence to surveillance mammography among a racially and ethnically diverse cohort of breast cancer survivors

Abstract Background: Annual mammography is a recommended component of post-treatment surveillance for breast cancer survivors and is associated with earlier detection of local recurrence and contralateral breast cancer. However, adherence to surveillance remains variable. Psychological distress, including depression and anxiety, has been proposed as a potential barrier. We investigated demographic, clinical, and mental health factors associated with adherence to surveillance mammography in a diverse cohort of breast cancer survivors. Methods: We conducted a retrospective cohort study of women diagnosed with stage 0-III breast cancer between 2018 and 2023 at Columbia University Irving Medical Center in New York, NY. We excluded women with stage IV disease, bilateral mastectomies, or less than 15 months of follow-up after breast cancer diagnosis. The primary outcome was receipt of at least one mammogram within 15 months of diagnosis. Psychological distress was defined using ICD-10 codes for depression and/or anxiety. Sociodemographic and clinical variables were extracted from the electronic medical record and tumor registry, including age at diagnosis, race and ethnicity, marital status, primary health insurance type, cancer stage, local and systemic treatments. Multivariable logistic regression was used to identify factors associated with adherence to surveillance mammography. Results: Among 1,970 eligible patients, the mean age was 59.2 years (SD, 11.9). The cohort included 33% Hispanic, 32% non-Hispanic White, 12% Black, and 5% Asian women. Overall, 94.6% (n=1,863) were adherent to surveillance mammography guidelines. On multivariable analysis, psychological distress was not significantly associated with adherence to surveillance mammography (odds ratio [OR]=0.89; 95% confidence interval [CI]=0.57-1.39). Compared to non-Hispanic White women, Hispanic ethnicity was associated with increased adherence (OR=1.95; 95% CI=1.15-3.28). Meanwhile, being married (OR=0.63; 95% CI=0.41-0.95) was associated with decreased adherence compared to being unmarried. Conclusions: In this large, racially and ethnically diverse urban breast cancer cohort, adherence to mammography surveillance was high. Psychological distress was not independently associated with non-adherence, suggesting that institutional supports may reduce its potential impact. Interestingly, Hispanic women had nearly 2-fold higher mammography adherence compared to their White counterparts, which may represent cultural differences or disparities in breast cancer worry or fear of recurrence. These findings highlight the importance of tailored survivorship care strategies to promote equitable adherence among breast cancer survivors. Citation Format: A. Antai, K. Crew, P. Kakani. Factors associated with adherence to surveillance mammography among a racially and ethnically diverse cohort of breast cancer survivors [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-04-24.