Receipt of Diagnostic Tests for Breast Cancer: Validity of Self-Reports Among Low-Income, Mostly Latina, Indigent Women

Little is known about the validity of self-reported completion of diagnostic testing after an abnormal breast cancer screening test. This study assesses the validity of self-reported diagnostic follow-up among 819 low-income, mostly Latina, indigent women with a breast abnormality at two public hospitals in Los Angeles County. Survey responses on receipt of a mammogram, ultrasound, fine needle aspiration, surgical biopsy, or clinical breast exam for diagnostic evaluation of the breast abnormality were compared to medical record data. The authors calculated concordance, Cohen's kappa statistic, and sensitivity and specificity. Kappa values indicated slight agreement for mammogram, ultrasound, and clinical breast exam, and moderate agreement for fine needle aspiration and surgical biopsy. Sensitivity of self-reports was high for all tests; specificity was poor for all tests except surgical biopsy. Self-reports of receipt of diagnostic testing for a breast abnormality among low-income, mostly Latina, indigent women are not accurate when compared to medical records.