Radiologist-led lectures can educate attendees about mammography, ease anxiety

Anxiety is often cited as a “harm” of screening mammography, perhaps most famously when the United States Preventive Services Task Force listed it, along with false-positives, as reasons average-risk women ages 40 to 49 should not get routine mammograms.

Free public lectures provided by radiologists can educate attendees about breast cancer screening while also decreasing their anxieties, according to a recent study published by the Journal of the American College of Radiology.

Jiyon Lee, MD, of the NYU School of Medicine department of radiology, and colleagues asked 117 women to fill out anonymous questionnaires before and after attending a structured lecture given by an academic breast radiologist.

The impact of such a lecture is important to monitor, the authors explained, because the ongoing debate over mammography has made it more difficult for patients to fully understand everything they need to know. In addition, different primary care physicians follow different screening recommendations, making the situation even more confusing for uncertain patients.

“Women may be unable to fully follow the complex ongoing debates, and clinicians may be underprepared to handle the breadth and depth of the ensuing questions,” the authors wrote. “Even if both were prepared and capable, not all women seek routine medical care to receive, or prompt, the shared decision-making discussion. Print media in widely available women’s magazines are variable in their handling of this topic, whereas educational materials from medical sources may have limited reach to only those women who are already patients.”

Answers to the questionnaire before the lecture showed that anxiety about mammography is, as the authors wrote, “neither as prevalent nor as immutable as seemingly portrayed.” Forty-two percent of women reported experiencing anxiety before a mammogram, and several women who did report anxiety specifically said they feel that way about all medical tests, not just mammograms.

Those who said they did feel anxiety, or could imagine other’s anxiety, most commonly reported anxiety over unknown results (more than 56 percent), the anticipation of pain (more than 21 percent), or knowledge of known risk factors (more than 14 percent). Other causes of anxiety that were mentioned included general uncertainty, waiting for results, the possibility of additional procedures, and a known history of breast cancer.

Another key statistic to come out of the questionnaires is that respondents had a better understanding of breast cancer screening after attending the lecture. On a scale of 1 to 5, with 1 representing no increase at all and 5 representing a maximum increase, the average response was 4.7. Using the same scale, respondents also said the lecture decreased their anxiety about mammography, with an average answer of 4.

Also, at least 92.5 percent of attendees correctly answered several key questions about mammography after the lecture. This included questions about whether a recall from a screening equaled a cancer diagnosis, the importance of clinical and self-breast exams, and if health habits reduce risk for breast cancer.

According to the authors, these results show the impact radiologists can have on patients by engaging them with sincerity, honesty and respect.

“Breast radiologists may generally be biased in favor of screening, but they can acknowledge that while still being fair, impartial, accurate, and complete in their presentations,” the authors wrote. “These sessions demonstrate the unique value-added potential of clinically experienced breast radiologists in educating women who may not otherwise be receiving balanced information regarding screening mammography. Education can empower and prepare women for informed decision making. It can also help ameliorate at least some of the normal and expected ‘anxiety’ regarding the screening experience that some, not all, women report.”