Re: Factors Influencing Patient Confidence in Screening Mammography

We read with great interest the article by Jarvis et al., published in the November 2023 issue of the Journal of the American Board of Family Medicine.¹ The authors underscore the importance of understanding factors associated with patients' confidence in screening mammography. Their study reveals that while 80% of women trust screening mammography, those with higher education (OR = 0.43; P = .02) and dense breast tissue (OR = 0.16; P = .004) report lower confidence. Factors such as age, race, and family history were not significant. These findings emphasize the need for enhanced education, particularly for women with dense breast tissue, regarding the efficacy of mammography.

As radiologists, we have observed that mammography and breast cancer detection often provoke negative emotions such as anxiety, discomfort, and worry, potentially impacting adherence to screening protocols and health outcomes. Thus, a patient-centered approach, which addresses emotional responses and prioritizes patient involvement, is essential. Recognizing the emotional impact of breast imaging, particularly in the context of evolving screening recommendations and cultural and socioeconomic barriers, is commendable.

In our practice, empowering patients through active involvement in decision making fosters better communication and ensures that their concerns are promptly addressed. This approach not only enhances the patient experience but can also improve health outcomes and adherence to recommendations. For example, same-day biopsies have been associated with higher satisfaction and reduced anxiety, as patients appreciate the prompt resolution of their concerns.³

At our institution, we extend our responsibilities beyond the procedure itself, ensuring the timely communication of pathology results and providing appropriate recommendations. We deliver potentially distressing results in a specialized space designed to reduce stress, ensuring that patients feel supported and heard.

In conclusion, Jarvis et al. present survey results highlighting that confidence in screening mammography is inversely associated with education level and self-reported increased breast density. This underscores the need for strategies to enhance patient-centered care in breast imaging. We recommend approaches such as effective communication, patient education, and creating supportive environments, which align with our experiences and emphasize the importance of a compassionate approach to improving both patient outcomes and overall satisfaction.