HOW DO BREAST IMAGING CENTERS COMMUNICATE RESULTS TO PATIENTS? RESULTS OF A NATIONAL SURVEY

Purpose: To describe current communication practices among a nationally representative sample of mammography centers.  

Methods: All members of the National Consortium of Breast Centers Inc., an association of more than 2,000 physicians, nurses, administrators, radiology technicians and others involved in breast care, were sent a 35-question online survey asking about their verbal, written, and telephone communication with patients, whether they employ patient navigators and staff with fluency in languages other than English, and whether and how they contact patients who do not follow-up.  Descriptive analysis of the sample and chi square testing was performed to distinguish differences between subgroups.

Results: Respondents from 243 centers completed the questionnaire (a 31 % response rate). Because of missing data, 221 centers (90.9%) were included in the analysis. Most centers (85.1%) reported no academic affiliation, and almost half (44.3%) reported performing 1,000 or more mammograms monthly. While most centers (81%) participated in programs designed to increase screening among low-income women, a minority (19%) reported that more than a quarter of their patients were publicly insured or uninsured.  At least 1 in 8 centers reported practices that may contribute significantly to communication barriers:  17.6% do not routinely telephone patients with results, 13.1% do not have multilingual staff or translators available to answer questions, and 68.8% send result letters in English-language only.  Of note, 69.7% use patient navigators. Centers targeting low-income women were more likely to provide a telephone number for patients to call with questions (p=0.0035), but less likely to have multilingual staff (p=0.0122). There were no significant differences between academic and non-academically-affiliated centers.

Conclusions: Effective communication of mammogram results is important to enhance shared decision making and to reduce patient anxiety and diagnostic delay. We found that centers report systemic strengths and barriers to clear communication of mammography results.  Many centers employ patient navigators, which may facilitate timely follow-up among patients who face barriers to access and understanding, but more than 2 in 3 centers present barriers to patients with Limited English Proficiency by only providing results in English. Future research should identify the relationship between these communication policies and women’s understanding of their results and adherence to follow-up.