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High Risk Breast Cancer Screening is a Double Edged Sword: A Qualitative Study of Patient Perspectives on the Ontario
Shirley Xiaoxuan Deng1, Matthew Castelo2, Emma Reel3
1Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Division of General Surgery, Department of Surgery, St. Michael's Hospital, Toronto, Ontario, Canada.
Clinical Breast Cancer
|September 20, 2022
Summary
High-risk women value MRI screening for breast cancer despite discomfort, finding reassurance outweighs false positives. Improvements in patient communication and support are recommended.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- MRI-based breast cancer screening is used for high-risk women.
- This screening method has been linked to false positives.
- Patient experiences with MRI screening are not well understood.
Purpose of the Study:
- To explore the benefits and drawbacks of MRI-based breast cancer screening.
- To understand patient perspectives on MRI screening experiences.
- To identify areas for improvement in MRI screening protocols.
Main Methods:
- Qualitative study utilizing semi-structured telephone interviews.
- Participants were women in the High Risk Ontario Breast Screening Program.
- Thematic saturation guided recruitment, with emergent themes identified.
Main Results:
- 21 women (median age 41) participated; 71% had abnormal screens, 38% biopsies.
- MRI was described as intimidating and claustrophobic; concerns about gadolinium contrast were raised.
- Despite distress from abnormal screens, MRI provided a "psychological safety net" valued by participants.
Conclusions:
- Women highly value the reassurance from sensitive MRI screening, outweighing the distress of abnormal results.
- Patient experiences highlight a "two-edged sword" trade-off for a sense of control.
- Improvements are needed in patient communication regarding MRI risks and psychosocial support.
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