Direct Interactive Public Education by Breast Radiologists About Screening Mammography: Impact on Anxiety and Empowerment.
OBJECTIVE
Anxiety has been called a "harm" of screening mammography. The authors provided direct, interactive education to lay audiences and measured these sessions' impact on anxiety and any increased understanding of breast cancer screening.


METHODS
Academic breast radiologist provided seven 1-hour sessions of structured lectures and question-and-answer periods. Lay language and radiologic images were used to discuss disease background, screening guidelines, and areas of debate. One hundred seventeen participants (mean age, 45 ± 15 years) completed voluntary, anonymous, institutional review board-approved pre and postsession questionnaires relaying their attitudes regarding screening and the impact of the sessions. Results are summarized descriptively.


RESULTS
Mean reported anxiety regarding screening (on a scale ranging from 1-5; 1 = no anxiety) was 2.5 ± 1.3. Anxiety was attributed to unknown results (56.4%), anticipation of pain (21.8%), known risk factors (14.5%), general uncertainty (12.7%), waiting for results (9.1%), possibility of more procedures (3.6%), and personal breast cancer history (3.6%). Ninety-seven percent reported that immediate results would lower anxiety (78% of those women indicated a 75%-100% decrease in anxiety); 93% reported that radiologist consultation with images would lower anxiety (75.6% indicated a 75%-100% decrease in anxiety). After the lecture, women reported (on a scale ranging from 1-5) increased understanding of the topic (4.7 ± 0.6), encouragement to screen (4.6 ± 0.7), and reduced anxiety (4.0 ± 1.1). Ninety-seven percent to 100% provided correct responses to these questions: rationale for screening in the absence of family history, recall does not equate to cancer diagnosis, benefit of prior films, and continued importance of physical examination.


CONCLUSIONS
Attendees of radiologist-provided direct public lectures reported decreased anxiety and improved knowledge regarding screening mammography. The resultant reduced anxiety ("harm") and educational empowerment help enable informed decision making and may promote screening attendance.
Department of Radiology, New York University School of Medicine, New York, New York. Electronic address: jiyon.lee@nyumc.org.
Jiyon
J
Lee
Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado.
Lara A
LA
Hardesty
Department of Radiology, New York University School of Medicine, New York, New York.
Nathan M
NM
Kunzler
Department of Radiology, New York University School of Medicine, New York, New York.
Andrew B
AB
Rosenkrantz
D001007:Anxiety / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000523:psychology*; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D006801:Humans; D008327:Mammography / Q000523:psychology*; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000379:methods / Q000523:psychology*; D015995:Prevalence; D000072177:Radiologists / Q000523:psychology / Q000706:statistics & numerical data*
Screening mammography; anxiety; breast radiologists; direct public education; informed shared decision making