Mismatch Between Older Persons' Generative Concern and Internalized Generative Capacities: Leveraging on Generative Ambivalence to Enhance Intergenerational Cohesion.

Studies have shown how generativity, the concern for establishing and guiding the next generation and safeguarding its wellbeing, functions as an intergenerational conduit, bridging the developmental stages of older individuals with those younger. Yet, applications of generativity, as a means to bridge generational gaps within rapid social change, remain underexplored in the intergenerational field. Using Singapore as a case study, and through focus group discussions with 103 older persons, this paper examines how older Singaporeans express their generative concern and internalize their generative capacities across different social settings and rapid socioeconomic transformation. Mismatch between older Singaporeans' generative concern and capacity contributes to ambivalence - mixed feelings about guiding younger generations - which emerges out of older Singaporeans' struggles with cultural change prompted by economic progress, as well as concerns about their place and value in a technologically advanced global city-state. The concept of generative ambivalence can add value to policy perspectives on intergenerational cohesion, as it considers people's attempts to forge commonalities and mutual reciprocity despite differences (e.g. gender, age, race, skills), as well as highlights intergenerational complexities beyond superficial binaries. Policies aimed at bringing generations together must be intentional in creating opportunity structures that go beyond categorical differences, where multiple generations can thrive interdependently.

Psychological well-being, quality of life and patient satisfaction among adults with chronic spontaneous urticaria in a multi-ethnic Asian population.

Patients with chronic spontaneous urticaria (CSU) have an increased risk of psychological distress. This cross-sectional study aimed to determine factors associated with psychological burden, quality of life (QoL) and patient satisfaction among adults living with CSU. Participants completed the self-administered Urticaria Activity Score-7 (UAS-7), Depression Anxiety Stress Scale (DASS 21), Dermatology Life Quality Index (DLQI), and Short Assessment Patient Satisfaction (SAPS) questionnaires. Multivariate logistic regression was used to determine the independent predictors of depression, anxiety, stress, QoL and patient satisfaction. From a total of 115 subjects with a median age of 42.6 years, range (19-89 years). 60.9% subjects reported moderate-to-severe CSU, 26.1% reported symptoms of depression, 54.8% had anxiety, 40.0% had stress, and 36.5% reported severely impaired QoL. The median UAS-7 score was 20 (IQR 11-27) while the median score of DLQI was 8 (IQR 4-13). The median score of SAPS was 20 (IQR 17-21). Low-income and severe disease were the significant predictors for depression while severe disease was predictive of impaired QoL and depression. Subjects who were diagnosed at older ages and those who required medical leave due to flares of CSU were less likely to be satisfied with their care. (192 words).

Predictive factors of sun protection behaviour among global airline pilots.

BACKGROUND: Airline pilots face significant ultraviolet radiation exposure resulting in an increased risk of sun damage and skin cancers. We aimed to evaluate sun-protective practices and associated factors among airline pilots. METHODS: We disseminated an online questionnaire evaluating the use of sunscreen, sunglasses, hats and protective clothing during daytime hours in the cockpit and during outdoor activities to 346 global commercial airline pilots, and we received 220 completed responses. The Pearson chi-squared test or Fisher's exact test where necessary were used to determine possible factors associated with the use of sun-protective practices. Potential confounders were adjusted for using multivariate analyses. RESULTS: The most common sun protective behaviour was the wearing of sunglasses during daytime flights (89.5%), followed by the use of caps during outdoor activities (47.7%). More pilots applied sunscreen during daytime flights (14.1%) compared with walk-arounds (8.2%). Males were less likely to use sunscreen during flights (adjusted odds ratio, aOR = 0.76), use sunscreen for walk-arounds (aOR = 0.175) and wear long sleeves (aOR = 0.013). Pilots who flew less than 30 h a month in high latitude regions were less likely to use a cap or hat outdoors (aOR = 0.419) or use sunscreen during walk-arounds (aOR = 0.241). Younger pilots were also less likely to use caps or hats outdoors (aOR = 0.446). CONCLUSION: Male pilots and those who spent less time in high latitudes were less likely to practice sun protection. Targeted educational efforts may be implemented to reduce occupational ultraviolet exposure.

A Comparative Study of Licochalcone A Moisturiser versus Topical Hydrocortisone in Treating Mild-to-Moderate Atopic Dermatitis

Background@#Topical corticosteroids are the mainstay of treatment for patients with atopic dermatitis. However, adverse effects associated with long-term steroid use often limit its use. This interventional study compared the efficacy of a proprietary moisturiser containing licochalcone A, omega-6 fatty acids, and ceramide 3 against 1% hydrocortisone cream in treating patients with mild-to-moderate atopic dermatitis.@*Methods@#Patients with mild-to-moderate atopic dermatitis affecting either the cubital fossa or popliteal fossa symmetrically were given twice-daily applications of the moisturiser and hydrocortisone on opposite sides of the body and monitored for a total of three weeks in a non-randomised half body, doubleblind study. Hydrocortisone was switched to aqueous cream after two weeks, whereas the application of the moisturiser continued until study completion. The assessment of SCORing Atopic Dermatitis (SCORAD) index and Dermatology Life Quality index was performed at baseline and every subsequent follow-up visit to measure patients’ response to treatment. @*Results@#The licochalcone A (LA) moisturiser and 1% hydrocortisone (HC) cream both demonstrated significant reduction in sign and symptom scores after only 1 week of treatment (percentage of reduction in sign and symptom scores: 52.8% [LA] vs 58.5% [HC]). Further reduction in mean sign and symptom scores for both treatments was observed at week 2 (61.3% [LA] vs 56.8% [HC]) and also at week 3 when HC was switched to aqueous cream (70.5% [LA] vs 63.5% [HC→aqueous cream]) (p<0.001 vs baseline within the same treatment arm at weeks 1, 2 and 3). When comparing the mean difference in SCORAD index for both individual as well as total skin signs and symptoms between LA and HC (i.e. inter-arm comparison), there was no significant difference between the two treatments for all the assessed parameters. Patients reported improvements in itching, sleeplessness, and overall quality of life over the course of treatment.@*Conclusion@#The licochalcone A moisturiser can be considered as an effective steroid-sparing alternative to topical corticosteroids in managing mild-to-moderate atopic dermatitis.

A Qualitative Study Exploring Singaporean Parents' Perceptions on PreParing their Child for Surgery.

PURPOSE: To explore the perceptions of parents regarding the preparation of their children for surgery. DESIGN AND METHODS: A qualitative descriptive study was conducted. Sixteen parents of children who were undergoing various types of elective surgery in a public tertiary hospital in Singapore were recruited. Data were collected through face-to-face interviews and analyzed using thematic analysis. RESULTS: Five themes were derived: (1) assumed roles of the parents; (2) communication, decision-making, and emotional challenges; (3) factors facilitating the preparation of children for surgery; (4) surgery-related and financial concerns; and (5) the desire for more information and better management. While preparing their children for surgery, parents undertook several roles to ensure readiness and to provide support. Parents faced challenges while communicating with their children regarding their surgeries, experiencing negative emotions and dilemmas in making decisions for surgery. Factors such as previous experiences, children's positive mentality, and access to information helped to facilitate their preparation. Parents expressed surgery-related concerns such as anesthesia and a successful outcome of the surgery, the timing of the surgery, and postoperative care. Parents expressed a desire for easier to understand information through the use of visual materials, and improvements in current practices and management. CONCLUSION: This study provides a greater understanding of parents' perceptions of their roles, challenges, influencing factors, concerns, and needs when preparing their children for surgery. PRACTICE IMPLICATIONS: The study findings provide insightful aspects for improving current healthcare practices and informing future research studies in exploring better surgery preparation programs for both parents and children.

Self-reported generalised pruritus among community-dwelling older adults in Malaysia.

BACKGROUND: The ageing skin is more susceptible to pruritic dermatoses, which are associated with adverse psychosocial effects and reduced quality of life among older adults. This cross-sectional study aimed to identify the burden of pruritus and factors associated with its presence and severity among older adults recruited to the Malaysian Elders Longitudinal Research study. METHODS: Seven hundred seventy individuals aged 55 years (lower age limit) and above were interviewed as to whether they experienced pruritus during the preceding week and the locations involved if present. The association between generalised pruritus, sleep quality, and major systemic risk factors were explored. RESULTS: 5.97% of respondents reported generalised pruritus. Generalised pruritus was associated with poorer sleep quality, with Pittsburgh Sleep Quality Index score above 6. Mean haemoglobin level was lower in subjects with generalised pruritus (13.14 g/dL) but there was no significant difference in the frequency of generalised pruritus and severe generalized pruritus between subjects with clinically defined anaemia. Also, there were no significant associations between other major systemic risk factors and generalised pruritus in this population-based study. There was no association between generalised pruritus with depression, anxiety or stress. CONCLUSION: The negative effect of pruritus on sleep quality suggests a possible deleterious effect of pruritus on health and quality of life. Further prospective research on the longer-term effects of pruritus on health status is now warranted. (222 words).

CHI study: protocol for an observational cohort study on ageing and mental health in community-dwelling older adults.

INTRODUCTION: Ageing is associated with a multitude of healthcare issues including dementia, depression, frailty, morbidity associated with chronic disease and high healthcare utilisation. With Singapore's population projected to age significantly over the next two decades, it has become increasingly important to understand the disease burden and etiological process among older adults. The Community Health and Intergenerational study aims to holistically examine ageing in place by investigating the resilience and vulnerability factors of the ageing process in the biological, psychological and social domains within the environment. METHODS AND ANALYSIS: Using a cohort multiple randomised controlled trial design, comprehensive health profiles of community-dwelling older adults will be collected. The objective is to recruit 1000 participants (aged 60-99 years) living in the western region of Singapore within a period of 3 years (2018-2020). Assessments include basic sociodemographic, physical health and function (cardiac, oral and blood profiles and visual function), cognitive functioning, daily functioning, physical fitness, emotional state, free-flowing speech, sleep quality, social connectedness, caregiver burden, intergenerational communication, quality of life, life satisfaction, attitudes to ageing and gratitude and compassion. Results from the cohort will enable future studies to identify at-risk groups and develop interventions to improve the physical and mental health and quality of life of older adults. ETHICS AND DISSEMINATION: Approval of the cohort study by the National University of Singapore Institutional Review Board (NUS-IRB Reference code: H-17-047) was obtained on 12 October 2017. Written consent will be obtained from all participants. Findings from the cohort study will be disseminated by publication of peer-reviewed manuscripts, presentations at scientific meetings and conferences with local stakeholders.

Miscible-Solvent-Assisted Two-Phase Synthesis of Monolayer-Ligand-Protected Metal Nanoclusters with Various Sizes.

Effective yet versatile synthetic strategies for size-tunable metal nanoclusters (NCs) are scarce. This has hampered the development of this unique class of nanomaterials. Here, a general protocol is reported for the synthesis of high-quality metal NCs protected by a variety of organic ligands (e.g., selenolate, thiolate, and phosphine) based on a miscible-solvent-assisted phase transfer between water and organic solution. This method is demonstrated to be facile, rapid (≤3 h), scalable (gram-scale), and versatile. The size of the selenolated and thiolated Au NCs can be tuned from Au10 to Au61 by simply varying the miscible solvent in proportions and types. The advantages of this method, such as quick phase separation and no need for purification treatment, enable real-time monitoring of metal NC growth within the NaBH4 reduction system. The results show that the size of Au NCs gradually increases with increasing valence electron count by a stepwise 2x e- hopping mechanism (x = 0-5), i.e., 0 e- → 2 e- → 4 e- → 8 e- → 18 e- → 22 e- → 32 e- .

Deep Neural Networks Improve Radiologists' Performance in Breast Cancer Screening.

We present a deep convolutional neural network for breast cancer screening exam classification, trained, and evaluated on over 200000 exams (over 1000000 images). Our network achieves an AUC of 0.895 in predicting the presence of cancer in the breast, when tested on the screening population. We attribute the high accuracy to a few technical advances. 1) Our network's novel two-stage architecture and training procedure, which allows us to use a high-capacity patch-level network to learn from pixel-level labels alongside a network learning from macroscopic breast-level labels. 2) A custom ResNet-based network used as a building block of our model, whose balance of depth and width is optimized for high-resolution medical images. 3) Pretraining the network on screening BI-RADS classification, a related task with more noisy labels. 4) Combining multiple input views in an optimal way among a number of possible choices. To validate our model, we conducted a reader study with 14 readers, each reading 720 screening mammogram exams, and show that our model is as accurate as experienced radiologists when presented with the same data. We also show that a hybrid model, averaging the probability of malignancy predicted by a radiologist with a prediction of our neural network, is more accurate than either of the two separately. To further understand our results, we conduct a thorough analysis of our network's performance on different subpopulations of the screening population, the model's design, training procedure, errors, and properties of its internal representations. Our best models are publicly available at https://github.com/nyukat/breast_cancer_classifier.

Characteristics of skin cancers among adult patients in an urban Malaysian population.

There has been a rising incidence of skin cancers among Asians in recent years. We present a retrospective analysis of 106 skin cancers and analysed the demography, clinical subtypes of skin cancers and surgical techniques used for skin cancer treatment. In our population, skin cancers were most frequently basal cell carcinomas and diagnosed among ethnic Chinese patients.

Overstated Harms of Breast Cancer Screening? A Large Outcomes Analysis of Complications Associated With 9-Gauge Stereotactic Vacuum-Assisted Breast Biopsy.

OBJECTIVE: The purpose of this study was to assess the rate, type, and severity of complications related to 9-gauge stereotactic vacuum-assisted breast biopsy (SVAB) and to delineate associated factors that may contribute to a higher rate of complications. MATERIALS AND METHODS: This retrospective study included 4776 patients who underwent SVAB between 2003 and 2016. A total of 319 patients with documented postbiopsy complications were identified. Complications were subcategorized as bleeding, pain, lightheadedness, bruising, and other complications, and their severity was classified as minor, moderate, or severe. Hematoma volumes were correlated with biopsy location and complication severity. A group of control subjects who underwent SVAB but had no complications was compared with the group of study patients with regard to age, biopsy location, lesion type, and pathologic findings. Postbiopsy screening adherence was assessed. Statistical analyses were performed using the Fisher exact, Mann-Whitney, Kruskal-Wallis, and Spearman rank correlation tests. RESULTS: Of the 319 patients with complications who were identified (representing 6.7% of the 4776 patients who underwent SVAB), 307 (96.2%) had mild complications, 12 (3.8%) had moderate complications, and no patients had severe complications. The most common complication was bleeding or hematoma (89.3% of patients [285/319]), followed by pain (6.9% [22/319]), lightheadedness (0.9% [3/319]), bruising (0.9% [3/319]), and other complications (1.9% [6/319]). No significant differences were noted between the study group and the control group in terms of age (p = 0.474), biopsy location (p = 0.065), histologic findings (p = 0.056), or lesion type (p = 0.568). Hematoma volume (median, 7.5 cm3) did not correspond to the severity of complications. Larger hematoma volumes were associated with a posterior biopsy location (p = 0.008). The rate of return to annual screening after biopsy was not adversely affected by the presence of biopsy complications. CONCLUSION: Clinically significant complications associated with SVAB were exceedingly rare (0.3%) in this large study spanning 13 years.

Lifelong learning and productive aging among the baby-boomers in Singapore.

Coined in 1982, the term productive aging is commonly associated with active participation in work, although it has since expanded beyond employment to include other dimensions of work, such as volunteering, caregiving and other activities that "produce(s) good/service for society, whether paid or unpaid" (Caro, Bass and Chen, 1993, p. 6). In this paper focusing on examining lifelong learning as one of the other activities in what comprises productive aging, we seek to explore the connections of lifelong learning to the notions of productive aging from the perspective of baby-boomers in Singapore. Using data from the qualitative study of Lifelong Learning among Older Adults in Singapore, which included 64 interviews with learners and non-learners of the baby-boomer generation (age 50-64), we first explore the grounded meanings of productive aging as articulated through lifelong learning. Next, we examine the benefits of lifelong learning as perceived by the baby-boomers, in particular, focusing on general wellbeing in enhancing productive aging. This is followed with a section examining barriers to lifelong learning to provide insight into deterrence to learning. Through the discussion of older adults' perceptions on lifelong learning and their engagement or lack of engagement especially with formal and non-formal learning, we hope to provoke a further re-thinking of what constitutes being productive in later life. Finally, we argue that beyond just another component to productive aging, lifelong learning should perhaps be further recognized as an enabler contributing to capacity-building of the other components including economic production, family care and volunteer services in enhancing productive aging.

Long-Term Care for Older Adults in ASEAN Plus Three: The Roles of Family, Community, and the State in Addressing Unmet Eldercare Needs.

OBJECTIVE: To introduce this Special Issue that focuses on understanding the issues surrounding the long-term care (LTC) in selected societies in Southeast and East Asian countries. METHOD: We first provide demographic and socioeconomic context for these countries and then summarize the seven articles in this issue. RESULTS: The articles highlight the rapidly rising demand for LTC in this region in the next few decades given the declining fertility, lengthening life expectancy, and increasing migration. They also discuss challenges and strategies in meeting these demands. Most countries are ill prepared to cope with the demand for LTC with older adults heavily rely upon female family members for care. Elderly women in low-income households have the greatest unmet need. DISCUSSION: Home-based and community-based services are set to become an integral part of the LTC system. It is important to incorporate older adults' cultural norms and wishes in their care plan and provision.

Strategic Design of Vacancy-Enriched Fe1- xS Nanoparticles Anchored on Fe3C-Encapsulated and N-Doped Carbon Nanotube Hybrids for High-Efficiency Triiodide Reduction in Dye-Sensitized Solar Cells.

A new class of hybrids with the unique electrocatalytic nanoarchitecture of Fe1- xS anchored on Fe3C-encapsulated and N-doped carbon nanotubes (Fe1- xS/Fe3C-NCNTs) is innovatively synthesized through a facile one-step carbonization-sulfurization strategy. The efficient synthetic protocols on phase structure evolution and dynamic decomposition behavior enable the production of the Fe1- xS/Fe3C-NCNT hybrid with advanced structural and electronic properties, in which the Fe vacancy-contained Fe1- xS showed the 3d metallic state electrons and an electroactive Fe in +2/+3 valence, and the electronic structure of the CNT was effectively modulated by the incorporated Fe3C and N, with the work function decreased from 4.85 to 4.63 eV. The meticulous structural, electronic, and compositional control unveils the unusual synergetic catalytic properties for the Fe1- xS/Fe3C-NCNT hybrid when developed as counter electrodes (CEs) for dye-sensitized solar cells (DSSCs), in which the Fe3C- and N-incorporated CNTs with reduced work function and increased charge density provide a highway for electron transport and facilitate the electron migration from Fe3C-NCNTs to ultrahigh active Fe1- xS with the electron-donating effect, and the Fe vacancy-enriched Fe1- xS nanoparticles exhibit ultrahigh I3- adsorption and charge-transfer ability. As a consequence, the DSSC based on the Fe1- xS/Fe3C-NCNT CE delivers a high power conversion efficiency of 8.67% and good long-term stability with a remnant efficiency of 8.00% after 168 h of illumination, superior to those of traditional Pt. Furthermore, the possible catalytic mechanism toward I3- reduction is creatively proposed based on the structure-activity correlation. In this work, the structure engineering, electronic modulation, and composition control opens up new possibilities in constructing the novel electrocatalytic nanoarchitecture for highly efficient CEs in DSSCs.

Hormonal Effects on Breast Density, Fibroglandular Tissue, and Background Parenchymal Enhancement.

Breast density, fibroglandular tissue, and background parenchymal enhancement (BPE) are recognized independent biomarkers for breast cancer risk. For this reason, reproducibility and consistency in objective assessment of these parameters at mammography (breast density) and at magnetic resonance imaging (fibroglandular tissue and BPE) are clinically relevant. However, breast density, fibroglandular tissue, and BPE are manifestations of dynamic physiologic processes and may change in response to both endogenous and exogenous hormonal stimulation. It is therefore important for the radiologist to recognize settings in which hormonal stimulation may alter the appearance of these biomarkers at imaging and to appreciate how such changes may affect risk assessment, cancer detection, and even prognosis. The purpose of this review article is therefore to review key features and means of evaluating breast density, fibroglandular tissue, and BPE at imaging; to detail how endogenous and exogenous hormonal stimuli may affect breast density, fibroglandular tissue, and BPE, potentially affecting radiologic interpretation; and, finally, to provide an update regarding current hormone treatment guidelines and indications that may result in imaging changes through hormone modulation. ©RSNA, 2018.

Determinants of quality of life and psychological status in adults with psoriasis.

We investigated whether disease severity and clinical manifestations were associated with depression, anxiety, stress and quality of life in adults with psoriasis. Participants were recruited from a dermatology outpatient clinic at a teaching hospital. Information on sociodemographic characteristics, disease severity, presence of arthropathy and head involvement was specifically recorded. Disease severity was assessed using the Psoriasis Area and Severity Index (PASI). Quality of life and psychological symptoms were measured using the Dermatology Life Quality Index (DLQI) and the Depression Anxiety Stress Scale (DASS), respectively. One hundred individuals were recruited. Unadjusted analysis revealed that head involvement was associated with depression [odds ratio (OR) 8.509; 95% confidence interval (CI) 1.077-67.231] and anxiety (OR 6.46; 95% CI 1.401-29.858). Severe disease was associated with a poorer quality of life compared to mild disease (OR 3.750; 95% CI 1.330-10.577). Younger age was associated with an increased risk of depression [mean difference (MD) - 8.640; 95% CI - 16.390 to - 0.890], anxiety (MD - 11.553; 95% CI - 18.478 to- 4.628), stress (MD - 11.440; 95% CI - 19.252 to - 3.628) and severely impaired quality of life (MD - 12.338; 95% CI - 19.548 to - 5.127). Following adjustments for age and disease severity, anxiety, stress and depression remained associated with severely impaired quality of life.

Stereotactic Breast Biopsy With Benign Results Does Not Negatively Affect Future Screening Adherence.

PURPOSE: To evaluate whether false-positive stereotactic vacuum-assisted breast biopsy (SVAB) affects subsequent mammographic screening adherence. MATERIALS AND METHODS: This Institutional Review Board-approved, HIPAA-compliant retrospective review of women with SVAB was performed between 2012 and 2014. Patient age, clinical history, biopsy pathology, and first postbiopsy screening mammogram were reviewed. Statistical analyses were performed using Fisher's exact, Mann-Whitney, and χ2 tests. RESULTS: There were 913 SVABs performed in 2012 to 2014 for imaging detected lesions; of these, malignant or high-risk lesions or biopsies resulting in a recommendation of surgical excision were excluded, leaving 395 SVABs yielding benign pathology in 395 women. Findings were matched with a control population consisting of 45,126 women who had a BI-RADS 1 or 2 screening mammogram and did not undergo breast biopsy. In all, 191 of 395 (48.4%) women with a biopsy with benign results and 22,668 of 45,126 (50.2%) women without biopsy returned for annual follow-up >9 months and ≤18 months after the index examination (P = .479). In addition, 57 of 395 (14.4%) women with a biopsy with benign results and 3,336 of 45,126 (7.4%) women without biopsy returned for annual follow-up >18 months after the index examination (P < .001). Older women, women with personal history of breast cancer, and women with postbiopsy complication after benign SVAB were more likely to return for screening (P = .026, P = .028, and P = .026, respectively). CONCLUSION: The findings in our study suggest that SVABs with benign results do not negatively impact screening mammography adherence. The previously described "harms" of false-positive mammography and biopsy may be exaggerated.

What Happens after a Diagnosis of High-Risk Breast Lesion at Stereotactic Vacuum-assisted Biopsy? An Observational Study of Postdiagnosis Management and Imaging Adherence.

Purpose To assess adherence with annual or biennial screening mammography after a diagnosis of high-risk lesion(s) at stereotactic biopsy with or without surgical excision and to identify clinical factors that may affect screening adherence after a high-risk diagnosis. Materials and Methods This institutional review board-approved HIPAA-compliant retrospective study included 208 patients who underwent stereotactic biopsy between January 2012 and December 2014 that revealed a high-risk lesion. Whether the patient underwent surgical excision and/or follow-up mammography was documented. Adherence of these women to a protocol of subsequent mammography within 1 year (9-18 months) or within 2 years (9-30 months) was compared with that of 45 508 women with normal screening mammograms who were imaged during the same time period at the same institution. Possible factors relevant to postdiagnosis management and screening adherence were assessed. Consultation with a breast surgeon was identified by reviewing clinical notes. Uptake of pharmacologic chemoprevention following diagnosis (patient decision to take chemopreventive medications) was assessed. The Fisher exact test was used to compare annual or biennial screening adherence rates. Binary logistic regression was used to identify factors predictive of whether women returned for screening within selected time frames. Results In total, 913 (1.3%) of 67 874 women were given a recommendation to undergo stereotactic biopsy, resulting in diagnosis of 208 (22.8%) of 913 high-risk lesions. Excluding those with a prior personal history of breast cancer or upgrade to cancer at surgery, 124 (66.7%) of 186 women underwent surgery and 62 (33.3%) did not. Overall post-high-risk diagnosis adherence to annual or biennial mammography was similar to that in control subjects (annual, 56.4% vs 50.8%, P = .160; biennial, 62.0% vs 60.1%, P = .630). Adherence was significantly better in the surgical group than in the nonsurgical group for annual mammography (70.0% vs 32.0%; odds ratio [OR] = 5.0; 95% confidence interval [CI]: 2.4, 10.1; P < .001) and for biennial mammography (74.3% vs 40.0%; OR = 4.3; 95% CI: 2.1, 8.8; P < .001). Among the patients in the nonsurgical group, those adherent to annual or biennial mammography were significantly more likely to have seen a breast surgeon than the nonadherent women (annual, 77.3% vs 35.7%, P = .005; biennial, 67.9% vs 36.4%, P = .045). All patients receiving chemopreventive agents underwent a surgical consultation (100%; n = 21). Conclusion Although diagnosis of a high-risk lesion at stereotactic breast biopsy did not compromise overall adherence to subsequent mammographic screening, patients without surgical excision, particularly those who did not undergo a surgical consultation, had significantly lower imaging adherence and chemoprevention uptake as compared with their counterparts who underwent surgery, suggesting that specialist care may be important in optimizing management. © RSNA, 2018.