title: Older women's experience with a benign breast biopsy—a mixed methods study.
abstract: BACKGROUND
  Little is known about older women's experience with a benign breast biopsy.
  
  
  OBJECTIVE
  To examine the psychological impact and experience of women ≥ 65 years of age with a benign breast biopsy.
  
  
  METHODS
  Prospective cohort study using quantitative and qualitative methods.
  
  
  METHODS
  Three Boston-based breast imaging centers.
  
  
  METHODS
  Ninety-four English-speaking women ≥ 65 years without dementia referred for breast biopsy as a result of an abnormal mammogram, not aware of their biopsy results at baseline, and with a subsequent negative biopsy.
  
  
  METHODS
  We interviewed women at the time of breast biopsy (before women knew their results) and 6 months post-biopsy. At both interviews, participants completed the validated negative psychological consequences of screening mammography questionnaire (PCQ, scores range from 0 to 36 [high distress], PCQ ≥ 1 suggests a psychological consequence, PCQs <1 are reported at time of screening) and women responded to open-ended questions about their experience. At follow-up, participants described the quality of information received after their benign breast biopsy. We used a linear mixed effects model to examine if PCQs declined over time. We also reviewed participants' open-ended comments for themes.
  
  
  RESULTS
  Overall, 88% (83/94) of participants were non-Hispanic white and 33% (31/94) had a high-school degree or less. At biopsy, 76% (71/94) reported negative psychological consequences from their biopsy compared to 39% (37/94) at follow-up (p < 0.01). In open-ended comments, participants noted the anxiety (29%, 27/94) and discomfort (28%, 26/94) experienced at biopsy (especially from positioning on the biopsy table). Participants requested more information to prepare for a biopsy and to interpret their negative results. Forty-four percent (39/89) reported at least a little anxiety about future mammograms.
  
  
  CONCLUSIONS
  The high psychological burden of a benign breast biopsy among older women significantly diminishes with time but does not completely resolve. To reduce this burden, older women need more information about undergoing a breast biopsy.
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA, mschonbe@bidmc.harvard.edu.
authors.forename: Mara A
authors.initials: MA
authors.lastname: Schonberg
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Silliman
authors.forename: Long H
authors.initials: LH
authors.lastname: Ngo
authors.forename: Robyn L
authors.initials: RL
authors.lastname: Birdwell
authors.forename: Valerie
authors.initials: V
authors.lastname: Fein-Zachary
authors.forename: Jessica
authors.initials: J
authors.lastname: Donato
authors.forename: Edward R
authors.initials: ER
authors.lastname: Marcantonio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D001294:Attitude to Health; D001706:Biopsy / Q000523:psychology; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000523:psychology*; D055088:Early Detection of Cancer / Q000523:psychology*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000523:psychology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D036301:Qualitative Research