Acceptability of diagnostic tests for breast cancer.
OBJECTIVE
To assess the acceptability of new non-invasive breast cancer diagnostic tests intended to triage women in need of biopsy.


METHODS
Women who had abnormal screening tests and had been recommended to have a biopsy were invited to receive digital mammography, magnetic resonance imaging (MRI), and nuclear medicine evaluation (Tc-99m-sestamibi scanning) before biopsy. Participants completed a questionnaire about satisfaction and acceptability of the procedures. Satisfaction measured women's overall and test-specific satisfaction. Acceptability was measured by self-reported discomfort, embarrassment and women's preference in terms of willingness to pay to avoid a biopsy.


RESULTS
Women were satisfied with all of the potential diagnostic triage procedures. Most found the tests more comfortable than a routine mammogram (47, 50, and 66% undergoing MRI, digital mammography, and sestamibi scanning, respectively). Women who provided a response to willingness to pay questions (N = 43) were willing to pay an average of 611 dollars to have a test instead of a biopsy, if the test was as accurate as biopsy. The willingness to pay significantly decreased to 308 dollars if the test only had 95% accuracy. Those who had prior benign breast disease were less willing to pay for a test with 95% accuracy than those without this history.


CONCLUSIONS
Instead of immediate biopsy after an abnormal screening, these results suggest that women would find non-invasive triage tests acceptable, or preferable to biopsy if they were equally accurate or nearly equally accurate as a biopsy. New technologies to diagnose breast cancer should focus on decreasing discomfort as well as increasing test accuracy.
Liang
Wenchi
W
Department of Oncology, Georgetown University Medical Center, Georgetown University, Washington, DC 20007, USA. liangw1@georgetown.edu
Lawrence
William F
WF
Burnett
Caroline B
CB
Hwang
Yi-Ting
YT
Freedman
Matthew
M
Trock
Bruce J
BJ
Mandelblatt
Jeanne S
JS
Lippman
Marc E
ME
D000328:Adult; D000368:Aged; D001706:Biopsy / Q000523:psychology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000517:prevention & control / Q000523:psychology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000523:psychology; D008327:Mammography / Q000523:psychology*; D008403:Mass Screening / Q000523:psychology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D011877:Radionuclide Imaging; D014218:Triage / Q000379:methods; D014481:United States