Screening Guidelines and Supplemental Screening Tools: Assessment of the Adequacy of Patient-Provider Discussions

J Breast Imaging. 2019 Jun 4;1(2):109-114. doi: 10.1093/jbi/wbz019.

Abstract

Purpose: To assess breast imaging radiologists' perceptions of the adequacy of provider-patient discussions regarding the benefits and risks of screening mammography and supplemental screening in women with elevated risk and dense breasts.

Methods: A 36-item questionnaire developed by the Society of Breast Imaging Patient Care and Delivery Task Force was distributed electronically to Society of Breast Imaging members to evaluate patient communication, education, and screening practices. Data from the 11 items specifically pertaining to screening practices were analyzed.

Results: The response rate was 14% (275/1992). Seventy-four percent of survey respondents perceived provider-patient discussions regarding mammography screening guidelines as inadequate, and they agreed that provider-patient discussions regarding screening guidelines (82%) and supplemental screening for increased breast density (74%) should be standardized. Only 38% indicated that mammography screening guidelines are officially endorsed by their institution. Similarly, 37% reported that recommendations were up to the primary provider. Although most respondents include information about breast density in lay letters (73%) and radiology reports (89%), many feel that further patient education regarding breast density, supplemental screening, risk assessment, and screening guidelines should be performed by radiologists, and they are willing to provide additional patient education in these areas in practice.

Conclusions: Survey respondents perceived current provider-patient discussions about the risks and benefits of breast cancer mammography screening and supplemental screening as inadequate and felt that standards should be developed. Respondents reported a willingness to take on patient education as part of their daily practice. These findings could inform future initiatives for radiologists to contribute to enhancing provider-patient education.

Keywords: breast cancer screening guidelines; patient communication; patient education; referring provider education.