ASPO Abstracts
Patient response to receiving a notification of elevated breast cancer risk after regular screening mammogram
Category: Behavioral Science & Health Communication
Conference Year: 2021
Abstract Body:
Background: Population-based screening for breast cancer risk can identify unaffected women at
elevated risk and inform them of risk-management options. The James Cancer Hospital recently
began assessing risk for women undergoing routine screening mammography. Women found to
have ≥20% lifetime risk are notified – with their mammogram results via mail and electronic
medical record – that they may be at elevated risk of breast cancer and should consider consulting
a high-risk provider. This initial study examined findings from a subsample who participated 2-6
weeks post-notification.
Purpose: We sought to determine whether women noticed and understood the notification, and to
examine their reactions to the notification of elevated risk.
Methods: Of 415 women recruited, 150 (36%) completed the survey, which included items to
assess memory and comprehension of the notification, and whether participants had (a) seen a
healthcare provider since the notification, and (b) discussed breast cancer risk and management
options during that appointment.
Results: Participants (aged 40-69; mean=50.8 years) were mostly White (86%), well-educated
(77%), and with above-average income (65%). Most remembered receiving the notification (73%),
perceived the information not to be complex (73%), and were confident they understood the
notification (93%). Somewhat fewer (64%) remembered that the notification indicated they may be
at elevated risk for breast cancer, and 44% also recalled the suggestion to meet with a healthcare
provider about this risk. Of the 28 participants who had already seen any healthcare provider in the
few weeks since the notification, 50% discussed breast cancer risk during that appointment and
25% said they did so because of the notification. Discussions included family cancer history, actual
risk of developing breast cancer, and options for additional imaging or testing.
Conclusions: These findings indicate that population-based screening associated with routine
mammography can motivate women at elevated breast cancer risk to discuss their risk and
management options with a healthcare provider. For some proportion of women, however,
complementary communication strategies may also be needed to ensure they gain awareness of
their higher-risk status.
Keywords: high-risk notification, population-based screening for breast cancer