Mammography Experience Research Articles

Acceptability of de-intensified screening for women at low risk of breast cancer: a randomised online experimental survey

BackgroundRisk-stratified approaches to breast screening show promise for increasing benefits and reducing harms. But the successful implementation of such an approach will rely on public acceptability. To date, research suggests that while increased screening for women at high risk will be acceptable, any de-intensification of screening for low-risk groups may be met with less enthusiasm. We report findings from a population-based survey of women in England, approaching the age of eligibility for breast screening, to compare the acceptability of current age-based screening with two hypothetical risk-adapted approaches for women at low risk of breast cancer.MethodsAn online survey of 1,579 women aged 40–49 with no personal experience of breast cancer or mammography. Participants were recruited via a market research panel, using target quotas for educational attainment and ethnic group, and were randomised to view information about (1) standard NHS age-based screening; (2) a later screening start age for low-risk women; or (3) a longer screening interval for low-risk women. Primary outcomes were cognitive, emotional, and global acceptability. ANOVAs and multiple regression were used to compare acceptability between groups and explore demographic and psychosocial factors associated with acceptability.ResultsAll three screening approaches were judged to be acceptable on the single-item measure of global acceptability (mean score > 3 on a 5-point scale). Scores for all three measures of acceptability were significantly lower for the risk-adapted scenarios than for age-based screening. There were no differences between the two risk-adapted scenarios. In multivariable analysis, higher breast cancer knowledge was positively associated with cognitive and emotional acceptability of screening approach. Willingness to undergo personal risk assessment was not associated with experimental group.ConclusionWe found no difference in the acceptability of later start age vs. longer screening intervals for women at low risk of breast cancer in a large sample of women who were screening naïve. Although acceptability of both risk-adapted scenarios was lower than for standard age-based screening, overall acceptability was reasonable. The positive associations between knowledge and both cognitive and emotional acceptability suggests clear and reassuring communication about the rationale for de-intensified screening may enhance acceptability.

Based on the experience of combined mammography and ultrasound screening

Based on the experience of combined mammography and ultrasound screening

Australian radiographers’ awareness of cardiac implantable electronic devices (CIEDs) in mammographic imaging

IntroductionWomen presenting for mammography occasionally have pacemakers or other cardiac-implantable electronic devices (CIEDs) in situ. This research investigates Australian radiographers’ awareness of CIEDs in the diagnostic and screening settings. MethodsA survey of radiographers with mammography experience in Australia was conducted using SurveyMonkey™. Respondents were asked if they could confidently identify images of devices and whether they had imaged them mammographically. A Chi-squared test of independence was used to compare the association between demographics and CIED awareness. A value of p < 0.05 was deemed statistically significant. ResultsThere were 220 valid responses. All CIED types had been imaged. Most respondents had imaged a pacemaker (94.5%) and implantable cardioverter-defibrillator (ICD) (85.6%), compared to the three different implantable loop recorders (ILRs) (ILR-1: 63.4%; ILR-2: 14.1%; and IRL-3: 26.9% and the emerging subcutaneous ICDs (S-ICDs) (11.9%). Most respondents felt confident identifying the pacemaker (95%) and the ICD (86.1%). Only 19.4% of respondents could confidently identify the emerging S-ICD. ConclusionA lack of awareness of new and emerging devices may impact approaches to imaging and present significant risk to patients. The lack of studies comprehensively describing devices and their mammographic appearance to support radiographers’ knowledge and awareness highlights an urgent need to progress research in this area. Implications for practiceAs a part of continuing professional development, radiographers performing mammography must ensure they remain up to date with current and emerging technology, including CIEDs. This study has identified a lack of awareness of the different types of CIEDs currently being implanted and imaged, which may translate to unsafe imaging practices. There is an urgent need for further education to bridge this knowledge gap and ensure the safety of practice in imaging women with CIEDs. FootlineMammography: CIED Imaging

Interventions to improve patient experience in mammography: a scoping review protocol.

The objective of this review is to map the global evidence on interventions aiming to enhance the patient experience during mammography examination. Mammography is the examination of choice to detect breast cancer, which is the most common malignant condition among women globally. However, this examination can cause psychological distress, discomfort, and pain for patients. To limit these negative experiences, and to promote patient engagement in diagnostic and screening examinations, some interventions have been tested in clinical practice. Each intervention has key differing features that need to be explored in a scoping review. This mapping will help inform mammography professionals and researchers. This review will consider studies that focus on women, men, transgender, nonbinary, or intersexual persons undergoing diagnostic or screening mammography. It will consider studies evaluating interventions and reporting data on the patient experience. These interventions may, for instance, be related to the information provided, breast compression, relaxation, medication, or physical environment. The review will also describe the outcomes related to patient experience (eg, anxiety, pain, discomfort). The search strategy will aim to find published and unpublished studies and will be conducted in MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, and ProQuest Dissertation and Theses. Furthermore, three registries will be searched for ongoing studies. This review will be conducted following JBI methodology, utilizing the three-step search strategy with two independent reviewers performing study selection and data extraction. The results, frequencies, and conceptual categories will be presented in a tabular and narrative summary. Open Science Framework ( https://osf.io/fn865/ ).

A Mixed Method Approach to Examine Surveillance Mammography Experiences in Black and White Breast Cancer Survivors

PurposeThe use of surveillance mammography following a breast cancer (BC) diagnosis is associated with early detection of disease relapse and increased overall survival; yet Black women compared to White women have the lowest surveillance mammography rates, with limited explanation. To further understand this racial disparity the present study examines the association of mammography beliefs, knowledge, and healthcare delivery factors on receipt of surveillance mammography among Black and White breast cancer survivors. MethodsThis is a convergent parallel mixed method study design of an online survey and online focus groups among Black and White BC survivors (N = 266) recruited from community engagement. The online focus groups consisted of a series of theory-informed questions via social media platforms (eg Breastcancer.org, Quora, Reddit). An in-depth thematic analysis approach was used to extract themes from online focus group data. Bivariate (χ2) and multivariable logistic regression analyses were conducted using the survey data to examine associated factors with receipt of a surveillance mammography within 12 months (yes vs. no). Results76% (n = 177) of women were Black, 62% were <5 years since diagnosis, 98% had health insurance, with an age range from 23 to 79 (mean = 55) years. 72% of the sample received a surveillance mammogram relative to 27%. Women more frequently received a surveillance mammogram if they reported perceived mammography benefits (<.001), underwent lumpectomy (P< .001) and had health insurance (P = .04). Black women without communication about surveillance care with providers had a lower likelihood of receiving a surveillance mammogram (OR:0.09,95% CI: 0.01-0.45, P = .003). Thematic findings from online focus groups included motivators for receipt of surveillance mammograms: physician recommendation, regular physical exams, and knowledge of recommended guidelines. Barriers of non-receipt of surveillance mammograms included: transportation, medical cost/financial barriers, feeling ignored from providers, and medical mistrust. ConclusionWomen may require more individualized information regarding their surveillance care to support routine guideline concordant follow-up. Patient-provider-communication is an integral part of Black survivors’ surveillance care needs. Improving patient-provider communication for Black women's is necessary to address this group cancer care needs.

Evaluation of Radiographers’ Experience in Mammography: An Explanatory Study

Background: Similar to most imaging procedures, the high quality of images is a key factor in ensuring that mammography delivers its full potential benefits. Radiographers play a central role in the acquisition of high-quality images, as they are responsible for not only breast positioning and compression, but also quality control and patient care. Objectives: To identify the challenges and difficulties of radiographers in daily practice and to determine the main components of mammography that require further training and education. Patients and Methods: An online survey was conducted to collect data regarding the radiographers’ demographic data, institution profile, image assessment tools, mammography challenges, quality control, and continuing professional development. Results: A total of 73 radiographers participated in this study, the majority of whom were full-time radiographers with a bachelor’s degree in radiography. Less than half of the participants had been a mammographer for more than five years. The American College of Radiology (ACR) criteria were the most familiar image quality assessment tool (52%). The most frequently used scale to evaluate image quality was posterior breast tissue visualization on both craniocaudal (CC) and mediolateral oblique (MLO) views, followed by the pectoral muscle volume determined on the MLO view. Overall, positioning, artifacts, and compression were the main reasons for repeat mammography. Also, wheelchair-bound patients, overweight patients, and breast compression were the greatest challenges of patient positioning. Conclusion: This pilot study highlighted the importance of developing in-house training courses for radiographers, which focus on patient positioning, image quality assessment, and patient-centered needs to improve practice standards. However, further studies on a larger sample size are needed to validate the present results.

Contrast-enhanced digital breast tomosythesis and breast MRI to monitor response to neoadjuvant chemotherapy: patient tolerance and preference.

Contrast-enhanced digital breast tomosynthesis (CE-DBT) is a novel imaging technique, combining contrast-enhanced spectral mammography and tomosynthesis. This may offer an alternative imaging technique to breast MRI for monitoring of response to neoadjuvant chemotherapy. This paper addresses patient experience and preference regarding the two techniques. Conducted as part of a prospective pilot study; patients were asked to complete questionnaires pertaining to their experience of CE-DBT and MRI following pre-treatment and end-of-treatment imaging. Questionnaires consisted of eight questions answered on a categorical scale, two using a visual analogue scale (VAS), and a question to indicate preference of imaging technique. Statistical analysis was performed with Wilcoxon signed rank test and McNemar test for related samples using SPSS v. 25. 18 patients were enrolled in the pilot study. Matched CE-DBT and MRI questionnaires were completed after 22 patient episodes. Patient preference was indicated after 31 patient episodes. Overall, on 77% of occasions patients preferred CE-DBT with no difference between pre-treatment and end-of-treatment imaging. Overall experience (p = 0.008), non-breast pain (p = 0.046), anxiety measured using VAS (p = 0.003), and feeling of being put at ease by staff (p = 0.023) was better for CE-DBT. However, more breast pain was experienced during CE-DBT when measured on both VAS (p = 0.011) and categorical scale (p = 0.021). Our paper suggests that patients prefer CE-DBT to MRI, adding further evidence in favour of contrast-enhanced mammographic techniques. Contrast mammographic techniques offer an alternative, more accessible imaging technique to breast MRI. Whilst other studies have addressed patient experience of contrast-enhanced spectral mammography, this is the first study to directly explore patient preference for CE-DBT over MRI in the setting of neoadjuvant chemotherapy, finding that overall, patients preferred CE-DBT despite the relatively long breast compression.

Practice, Perception and Satisfaction Regarding Mammography among Saudi Females

The leading cause of death for women in developing nations is breast cancer. Mammography is a reliable screening technique for detecting breast cancer in its early stages. To measure Saudi females&#39; satisfaction, perception, and level of practice regarding their mammography experience. Between January 2021 and March 2021, a descriptive cross-sectional study was conducted. Participants&#39; information was gathered using an electronic pre-structured questionnaire. Through the use of social med

Using Mixed Methods with Multiple Stakeholders to Inform Development of a Breast Cancer Screening Decision Aid for Women with Limited Health Literacy

Research ObjectiveLittle is known about the best process for selecting content for decision aids (DAs) on mammography screening. This analysis triangulates perspectives (experts, primary care providers, and patients) to understand areas of divergent and convergent input across stakeholder groups in developing a breast cancer screening DA for women ages 40–54 with limited health literacy.Study DesignA 3‐round modified Delphi panel was conducted among national breast cancer screening and decision science experts. They rated the importance of 57 statements for possible inclusion in a breast cancer screening DA. Qualitative comments about each statement were collected via open‐ended text fields. Analysis was conducted following the RAND Appropriateness methodology. Separately, 25 women with limited health literacy (patients) and 20 primary care providers (PCPs) from outpatient clinics at a Boston‐based safety net hospital completed interviews exploring mammography‐related informational needs. To identify areas where stakeholder perspectives converged or diverged from each other, we conducted a qualitative synthesis using a constant comparison technique. Codes were developed and compared: (1) at the level of the individual interview; (2) within stakeholder groups; and, (3) across stakeholder groups.Population StudiedEight experts participated in the Delphi panel. Participants had an advanced degree (MD, PhD), &gt; 3 years of either professional, clinical or research experience, and content expertise in breast cancer screening, health literacy, or DA design. Patients included mammography‐eligible, primary care patients ages 40–54 with upcoming visits, and limited health literacy as defined by a score of &lt;7 on the Health Literacy Skills Instrument‐10. PCPs included physicians and nurse practitioners in family medicine or general internal medicine clinics.Principal FindingsIn the multi‐stakeholder synthesis, four themes regarding informational needs were identified related to: (a) the benefits and harms of screening, (b) different screening modalities, (c) the experience of mammography, and (d) communication about breast cancer risk. Convergence occurred around personal risk information, with all stakeholders describing it as important. Divergence occurred within the other three themes. Patients viewed pain as the primary harm, while PCPs and experts emphasized false positives as the primary harm. Process information about the mammography experience was critical to patient decisions; Experts and PCPs described process as less relevant. Patients valued breast self‐exam information, while PCPs and experts did not since self‐exams have been shown to be ineffective.ConclusionsWhile experts and PCPs prioritized providing evidence‐based options only, emphasized technology‐related harms, and downplayed the relevance of delivering mammography process information, patients were more concerned about pain, breast self‐exam (which is not supported by evidence), and viewed process information as fundamental to their decision‐making. These differences indicate opportunities to address patient‐identified unmet informational needs in breast cancer screening DAs.Implications for Policy or PracticeEvidence and guidance to advance best practices in integrating diverse and potentially divergent input across groups in DAs is warranted. Greater integration of patient voices, especially of those who are underserved, requires additional efforts to address patients' informational needs, which may differ from expert‐ and PCP‐defined priorities.Primary Funding SourceNational Institutes of Health.

The role of self-evaluation and education of radiographers involved in a breast cancer screening program at Clinical Hospital Center Rijeka

IntroductionEarly breast cancer detection can be achieved by enforcing the quality of mammography screening program. Hence, proper breast positioning is necessary. Systematic education of radiographers on mammographic positioning is a prerequisite for obtaining high-quality mammograms. The aim of this study is to demonstrate the importance of self-evaluation and education of radiographers involved in a breast cancer screening program. MethodsThe First School of Mammographic Positioning was organized in 2018 at Clinical Hospital Center (CHC) Rijeka and 24 radiographers included in the screening program attended. Four months after the School, an analysis and comparison of randomly selected mammograms was performed. Retrospective analysis was performed, and two sets of collected data were gathered from the period before and after the education. The quality criteria for evaluation were set and the mammograms were independently analyzed by two radiographers with experience in mammography. The chi-square test was used to perform statistical analysis. ResultsResults showed a statistically significant difference in the quality of mammograms before and after training for all criteria (p < 0.05). ConclusionSelf-evaluation and education of radiographers at the CHC Rijeka have led to a significant progress in image quality. Implications for practiceResults of this work imply that there is a strong need to formalize breast imaging education and the need to implement systematic education at the national level in Croatia.

Using Mixed Methods With Multiple Stakeholders to Inform Development of a Breast Cancer Screening Decision Aid for Women With Limited Health Literacy.

Background. When stakeholders offer divergent input, it can be unclear how to prioritize information for decision aids (DAs) on mammography screening. Objectives. This analysis triangulates perspectives (breast cancer screening experts, primary care providers [PCPs], and patients with limited health literacy [LHL]) to understand areas of divergent and convergent input across stakeholder groups in developing a breast cancer screening DA for younger women with LHL. Design. A modified online Delphi panel of 8 experts rated 57 statements for inclusion in a breast cancer screening DA over three rounds. Individual interviews with 25 patients with LHL and 20 PCPs from a large safety net hospital explored informational needs about mammography decision making. Codes from the qualitative interviews and open-ended responses from the Delphi process were mapped across stakeholders to ascertain areas where stakeholder preferences converged or diverged. Results. Four themes regarding informational needs were identified regarding 1) the benefits and harms of screening, 2) different screening modalities, 3) the experience of mammography, and 4) communication about breast cancer risk. Patients viewed pain as the primary harm, while PCPs and experts emphasized the harm of false positives. Patients, but not PCPs or experts, felt that information about the process of getting a mammogram was important. PCPs believed that mammography was the only evidence-based screening modality, while patients believed breast self-exam was also important for screening. All stakeholders described incorporating personal risk information as important. Limitations. As participants came from one hospital, perceptions may reflect local practices. The Delphi sample size was small. Conclusions. Patients, experts, and PCPs had divergent views on the most important information needed for screening decisions. More evidence is needed to guide integration of multiple stakeholder perspectives into the content of DAs. Article HighlightsThis study combines data from patients with limited health literacy, primary care providers (PCPs), and experts to examine priorities for information inclusion in a breast cancer screening decision aid.All stakeholders described including personal risk information as important.While experts and PCPs prioritized providing evidence-based screening options only, emphasized false positives as the primary mammography harm, and downplayed the relevance of delivering mammography process information, patients had a broader scope of harms (e.g., pain), wanted more information on breast self- exam, and viewed process information as fundamental to their decision making.This study demonstrates that there are differences in what doctors and experts prioritize communicating about breast cancer screening and what patients want to learn about.

The influence of breast density and key demographics of radiographers on mammography reporting performance - a pilot study.

IntroductionA high demand has been placed on radiologists to perform screen reads due to higher number of women undergoing mammography. This study aims to examine radiographer performance in reporting low compared with high‐mammographic density (MD) images; and to assess the influence of key demographics of Jordanian radiographers on their performance.MethodsThirty mammograms with varied MD were reported by 12 radiographers using the Breast Imaging‐Reporting and Data System (BI‐RADS). Radiographer performance was measured using sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and area under the receiver operating characteristic curve (ROC AUC). Performance measures were compared between cases with low‐ and high‐MD and between subgroups of radiographers according to key demographics.ResultsAll performance measures were significantly higher in low‐ compared to high‐MD cases (P value < 0.0). The mean sensitivity, specificity, PPV, NPV and ROC AUC were 0.58, 0.68, 0.67, 0.63 and 0.69 respectively. PPV was significantly different for readers who had different years of experience in mammography, hours and cases per week P value = 0.023, 0.01, 0.017 respectively. ROC AUC was significantly different for radiographers with different number of hours and cases performed per week (P value = 0.001 and 0.004 respectively).ConclusionsThe results of this pilot study are encouraging however a more extensive study is required to determine if Jordanian radiographers are capable of successfully taking part in breast screen reading. The lack of skills and knowledge required for correct and consistent reporting of high‐MD images highlights the need for any formal training in mammographic interpretation to focus on the dense breast.

Breast cancer detection: Comparison of digital mammography and digital breast tomosynthesis across non-dense and dense breasts

IntroductionBreast density is associated with an increase in breast cancer risk and limits early detection of the disease. This study assesses the diagnostic performance of mammogram readers in digital mammography (DM) and digital breast tomosynthesis (DBT). MethodsEleven breast readers with 1–39 years of experience reading mammograms and 0–4 years of experience reading DBT participated in the study. All readers independently interpreted 60 DM cases (40 normal/20 abnormal) and 35 DBT cases (20 normal/15 abnormal). Sensitivity, specificity, ROC AUC, and diagnostic confidence were calculated and compared between DM and DBT. ResultsDBT significantly improved diagnostic confidence in both dense breasts (p = 0.03) and non-dense breasts (p = 0.003) but not in other diagnostic performance metrics. Specificity was higher in DM for readers with >7 years' experience (p = 0.03) in reading mammography, non-radiologists (p = 0.04), readers who had completed a 3–6 months training fellowship in breast imaging (p = 0.04), and those with ≤2 years’ experience in reading DBT (p = 0.02), particularly in non-dense breasts. ConclusionDiagnostic confidence was higher in DBT when compared to DM. In contrast, other performance metrics appeared to be similar or better with DM and may be influenced by the lack of experience of the reader cohort in reading DBT. Implications for practiceThe benefits of DBT may not be entirely accrued until radiologists attain expertise in DBT interpretation. Specificity of DBT varied according to reader characteristics, and these characteristics may be useful for optimising pairing strategies in independent double reading of DBT as practiced in Australia to reduce false positive diagnostic errors.

Abstract PS3-23: Experience of contrast-enhanced mammography in patients with breast augmentation surgery

Abstract Background: Contrast-enhanced mammography (CEM) is an emerging breast imaging technique utilizing iodinated contrast to highlight areas of neovascularity. The role of CEM in patients with breast implants has not yet been characterized. We report our clinical experience of CEM in patients with breast augmentation surgery to better understand the potential diagnostic utility and limitations of CEM in the setting of breast implants. Materials and Methods: A HIPPA compliant, IRB exempt single-institution review of prospective CEM cases who had “breast implants” in their report between 01/2015 and 03/2020. Medical records were reviewed to supplement database information. Results: Forty-six patients were included with a mean age of 52 years (range 33-72). Clinical indications included: high risk research screen 3 (6%), diagnostic evaluation for abnormal imaging 24 (52%), further evaluation of newly diagnosed breast cancer 12 (26%) or assessment of neoadjuvant treatment response 7 (15%). Thirty patients had malignant lesions. Histology was invasive ductal carcinoma (90%), invasive lobular carcinoma (7%), and ductal carcinoma in situ (3%). CEM identified the index cancer and extent of disease in 28/30 (93%) of malignant cases. In two patients (7%), the malignant lesion was not included in the field-of-view due to its location. One of these lesions was a far medial mass within the breast which was detected by ultrasound alone. The other false negative CEM was a palpable axillary mass negative on both mammogram (MG) and MRI but seen by ultrasound. Twenty-three (50%) underwent additional breast MRI of which 20 had an already diagnosed cancer. the findings on CEM were concordant with MR imaging for the index lesion in 19/20 (95%) cases (kappa=0.86; p &amp;lt;0.001). Six additional lesions were found by CEM and confirmed by MRI. Of these lesions, 33% were found to be malignant and changed the surgical procedure. Four were only seen on CEM (no MRI comparison was available) and 75% were found to be malignant. One was only seen on MRI and was benign. One additional lesion was only seen as an asymmetry on MG without CEM or MRI correlate. This was benign on both the biopsy and surgical pathology. Conclusions: CEM appears to be a valuable breast imaging modality for diagnostic evaluations and surgical staging, including patients with breast implants. Due to technical artifacts and positioning limitations for posterior lesions, we recommend performing CEM with implant displaced views. Breast centers that use CEM, should be aware of field of view as a potential limitation when evaluating extent of disease in patients with breast augmentation. Citation Format: Molly Carnahan, Barbara Pockaj, Victor Pizzitola, Marina Giurescu, Roxanne Lorans, William Eversman, Richard Sharpe, Patricia Cronin, Donald Northfelt, Karen Anderson, Brenda Ernst, Bhavika Patel. Experience of contrast-enhanced mammography in patients with breast augmentation surgery [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS3-23.

Does prioritizing patient safety during the COVID-19 pandemic come at the expense of patient satisfaction?

Does prioritizing patient safety during the COVID-19 pandemic come at the expense of patient satisfaction?

Covid-19: A V shaped recovery for the NHS?

<h3>Objectives:</h3> To determine the association of different factors in the mammography related pain perception of women who attended their screening and diagnostic mammography appointments and whether the pain perceived was equal to the pain experienced. <h3>Methods:</h3> This prospective study was conducted at the Breast Unit of King Abdulaziz University (KAU) Hospital, Jeddah, Kingdom of Saudi Arabia (KSA), in the period between April and May 2015. A structured questionnaire with close-ended questions was given to a sample of 100 women before and after their mammogram, asking about their pain perception and whether it had changed. <h3>Results:</h3> The factors that affected anticipated mammography pain for the surveyed women were past mammography experiences, previous breast procedures, and the knowledge that was gathered beforehand about mammography. After the mammography, the women who thought the procedure was going to be painful experienced what they expected. The majority of the women who did not expect the mammography to be painful experienced pain during their mammogram. Most of the women who did not know whether it would be painful or not experienced the mammography as painful. <h3>Conclusion:</h3> Pain expectation can be approached in various ways to make the mammography experience much more tolerable for women, encouraging them to attend and return for their scans.

Anxiety and Pain Level Associated with Mammography and the Impact of the Preexistence of Knowledge

Background: Breast cancer is the most common type of cancer in women, after skin cancer. Early detection and treatment are recommended for reducing mortality and suffering. However, screening behaviors are often avoided for many reasons, such as anxiety and stress. Mammography screening is the main recommended test for the early detection of breast cancer. The objective of this study was to assess the knowledge, level of pain, and stress in women during the early screening of breast cancer with a mammogram. Materials and methods: This study has been approved by the Local Research Ethics Committee. The study was conducted at Hafr Elbatin Central Hospital in Saudi Arabi among 100 women. Data were collected via a structured interview questionnaire before and immediately after the mammography procedure. The questionnaire consisted of three parts: (1) sociodemographic data and knowledge about the mammogram examination, (2) pain scale, and (3) anxiety scale. Data were entered and analyzed using SPSS version 25. Results: A total of 75% (n=75) of the women reported moderate to severe pain during the mammogram examination. Up to 57% (n=57) of the women expressed severe anxiety about the mammogram procedure. Most of the women-85% (n=85)-were found to have poor knowledge related to mammograms and mammogram preparation. There was a strong correlation between pain before and during the mammogram procedure, P-Value (0.00001*) with Chi-squared (33.40) and a highly significant correlation between satisfactory and unsatisfactory knowledge in women's P-Value (0.00001*) with z test (6.57). A poor knowledge about breast cancer was detected in the overall studied women and those who had never undergone mammography, particularly knowledge related to the risk factors for breast cancer. The most important predictors of the barriers to mammography were incorrect beliefs about mammography and its procedures. Conclusion: Pain expectations can be approached in various ways to make the mammography experience much more tolerable for women, thereby encouraging them to attend and return for their scans. It was determined that women who had mammography had a moderate level of anxiety.

Factors affecting mammography screening behaviour among rural Vietnamese women.

To identify factors associated with mammography screening behaviour and its predictors among rural Vietnamese women. A predictive correlational study involving 120 women aged≥40years was conducted in the suburbs of Hanoi, Vietnam, in July 2018 by using Breast Cancer Awareness Measurement and the Champion Health Beliefs Model Scale. Mammography screening behaviour was assessed by asking participants about their previous mammography experience. Only 16.7% of participants had undergone mammography screening. High education levels, high monthly family income, having family members or friends with breast cancer, and receiving physicians' recommendations increased the likelihood of participants screening for breast cancer. Mean scores on perceived susceptibility and perceived barriers differed significantly between participants who had and those who had not undergone screening (t=4.31; p<.001; t=-5.05; p<.001, respectively). Perceived susceptibility and perceived barriers significantly increased the predictive power of the hierarchical logistic model (critical value=6.16; [df=2]; p=.046). Perceived barriers were the most significant predictors of screening behaviour (odds ratio 0.84; 95% CI, 0.71-0.99; p=.039). Efforts are necessary to increase mammography awareness in the community and promote screening rates in Vietnam.

Abstract B111: Previous mammography experience as a predictor of mammography adherence among Hispanic/Latinas living in the Northeast United States

Abstract Background: Similar to non-Hispanic Black women, Hispanic/Latino women are more likely to be diagnosed with later-stage breast cancer than White women, and their mammography screening rates are lower than those of both groups. Although the literature generally focuses on women's behavior to identify predictors of mammography screening, we hypothesized that selected factors associated with prior mammography experience would impact future screening. From a large prospective study of cancer screening in Hispanic/Latinas living in the Northeast US, the purpose of this investigation was to determine how previous mammography experiences influenced adherence to mammography screening guidelines over 2.5-4 years of follow-up. Methods: Among 1,456 community-living Hispanic/Latinas ages 40 to 75 who had received at least one screening mammogram at the time of their baseline interview and consented to medical record review, we considered “mammography experience” in predicting annual screening mammography (documented screening mammogram within 12 months + 1-month lag time), in accordance with recommendations promulgated by the American Cancer Society (and widely followed) during the study period. Using multivariate logistic regression, we identified independent predictors of adherence to recommended guidelines after adjusting for core sociodemographic, access to care, and medical factors. Key predictors included characteristics of provider (gender, race/ethnicity), ease of communication and use of interpreters, being treated with respect, believing that mammography-related pain was minimized as much as possible, communication of results, and general satisfaction. Odds Ratios (ORs) and 95% Confidence Intervals (CI) are reported. Results: 54% of Hispanic/Latino women were adherent to recommended mammography screening guidelines over the follow up period. Although needing help with communicating with medical staff and not speaking the same language as the radiologic technologist were significant in bivariate analyses, only 2 “experience” variables were significant predictors after multivariate adjustment: 1) Women who were told the results of their earlier mammogram at the time of the test were less likely (OR= 0.80; 95% CI 0.63, 0.97) to adhere to annual screening guidelines compared to patients who were not told their results; and 2) compared to women who did not have a usual care provider, having a female doctor increased a woman's odds of being compliant with recommended guidelines (OR = 1.40, 95% CI 1.05, 1.77), whereas having a male usual care provider did not (OR = 0.86, 95% CI 1.05, 1.77). Conclusion: In a prospective look at adherence to mammography screening guidelines in Hispanic/Latino women living in the Northeast US, having a female usual care provider was associated with adherence to mammography screening guidelines. This finding requires further study, particularly in this subpopulation. Citation Format: Beth A. Jones, Krisha Patel, Inginia Genao, Marcella Nunez-Smith, Claus Elizabeth, Hosanna Soler-Vila, Markowski Justin. Previous mammography experience as a predictor of mammography adherence among Hispanic/Latinas living in the Northeast United States [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B111.

A comparative study of pain experienced during successive mammography examinations in patients with a family history of breast cancer and those who have had breast cancer surgery

IntroductionTo measure mammography-related pain in two groups of women undergoing regular surveillance as a baseline for future care. MethodsFollowing ethical approval, two hundred and forty two women aged 32–84 years (mean 54), were invited by written invitation to participate in the study. Two hundred women accepted the invitation, 100 women had a family history (FH) of breast cancer, 100 had undergone conservative surgery (FU) for breast cancer and were currently asymptomatic. A validated pain scale was used to score the participants' perceived pain before compression based on memory, immediately after compression and one week later. A series of baseline parameters were also captured including compression force, breast size/density, menstrual history and any adverse events following mammography to allow the investigation of relationships. ResultsThere was a strong correlation (r = 0.79, p < 0.001) between previous pain scores and current pain scores, no significant correlations were found between breast size, breast density or total compression force and pain. Pain scores reduced between previous and current examinations and there was consistency in overall pain scores, despite variations in the compression forces applied. ConclusionPhysical side effects from mammography can develop and extend beyond the examination period. Patients' prior experience of pain was the only significant predictor of current pain in this study. Implications for practiceData on past mammography experiences are essential to improve future pain outcomes. Post-mammography aftercare should be a routine feature of the examination.