title: Screening Mammography: Patient Perceptions and Preferences Regarding Communication of Estimated Breast Cancer Risk.
abstract: OBJECTIVE
  Many models exist to estimate a woman's risk of development of breast cancer. At screening mammography, many imaging centers collect data required for these models to identify women who may benefit from supplemental screening and referral for cancer risk assessment. The purpose of this study was to discern perceptions and preferences of screening mammography patients regarding communication of estimated breast cancer risk.
  
  
  METHODS
  An anonymous survey was distributed to screening and surveillance mammography patients between April and June 2015. Survey questions were designed to assess patient preferences regarding the receipt and complexity of risk estimate communication, including hypothetical scenarios with and without > 20% estimated risk of breast cancer. The McNemar test and the Wilcoxon signed rank test were used with p ≤ 0.05 considered statistically significant.
  
  
  RESULTS
  The survey was distributed to 1061 screening and surveillance mammography patients, and 503 patients responded (response rate, 47%). Although 86% (431/503) of patients expressed interest in learning their estimated risk, only 8% (38/503) had undergone formal risk assessment. The preferred method (241 respondents [26%]) of communication of risk < 20% was a mailed letter accompanying annual mammogram results. For risk > 20%, patients preferred oral communication and were 10-fold as likely to choose only oral communication (p < 0.000001). For risk < 20% and > 20%, patients preferred to learn their estimated risk in great detail (69% and 85%), although women were significantly more likely to choose greater detail for risk > 20% (p < 0.00001).
  
  
  CONCLUSIONS
  Screening mammography patients expressed interest in learning their estimated risk of breast cancer regardless of their level of hypothetical risk.
authors.affiliation: 1 Department of Radiology, Massachusetts General Hospital, Boston, MA.|2 Present address: Seattle Cancer Care Alliance, Seattle, WA.
authors.forename: Nita
authors.initials: N
authors.lastname: Amornsiripanitch
authors.affiliation: 1 Department of Radiology, Massachusetts General Hospital, Boston, MA.
authors.forename: Mark
authors.initials: M
authors.lastname: Mangano
authors.affiliation: 1 Department of Radiology, Massachusetts General Hospital, Boston, MA.
authors.forename: Bethany L
authors.initials: BL
authors.lastname: Niell
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003142:Communication; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D057240:Patient Preference; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States
keywords: breast MRI; communication; patient centered; risk assessment; screening mammography