Assessing Patient Satisfaction with Mammography Using Patient-Reported Measures: A Prospective Observational Study

Negative experiences during mammography can reduce patient's adherence. Yet patient-reported measures focusing on the diagnostic pathway remain limited, particularly in general radiology departments that are not specialized in breast imaging only. This prospective study evaluated the overall patient satisfaction with digital mammography (DM) using a tailored patient-reported experience measure (PREM) and examined associations with personal, clinical, and procedural factors to identify actionable quality-assurance targets.

Women undergoing DM or digital breast tomosynthesis for screening, surveillance, follow-up of high-risk lesions, or diagnostic clarification at a medium-sized general hospital were recruited between February and July 2023. Of 885 eligible women, 549 (62%) aged 29-88 years completed a validated 23-item PREM questionnaire. Associations between satisfaction and personal (age, anxiety, pain), clinical (breast density, cancer history), and procedural factors (radiographer communication, radiologist consultation) were assessed using Fisher's exact test, Kendall's tau-b (τb) correlations, and ordered logistic regression. Significance was set at p < 0.05. Free-text comments were analyzed using IRaMuTeQ to identify thematic clusters.

Overall, 78% (428/549) of participants reported full satisfaction with DM. Satisfaction was significantly related to personal and procedural factors (p < 0.05), particularly anxiety (τb = -0.2), pain (τb = -0.3), age (τb = 0.1), radiographer communication (τb = 0.3), and efforts to reduce discomfort (τb = 0.4). Consultations with a breast radiologist immediately after DM markedly increased the likelihood of full satisfaction (+14 percentage points). In contrast, clinical variables, including breast cancer history, breast density, and familial risk, showed no significant association with satisfaction (p > 0.05). Free-text analysis revealed four influencing dominant themes: waiting time before radiologist consultation, staff competence, gratitude toward radiographers and radiologists, and the physical environment of examination rooms.

Patient satisfaction with DM in a nonspecialized general radiology department is predominantly shaped by modifiable procedural and interpersonal factors rather than clinical factors. Radiographers' communication and efforts to reduce discomfort emerged as key determinants of satisfaction, alongside immediate result communication by radiologists. PREMs are feasible to implement in routine breast imaging workflows and offer valuable insights for quality assurance and patient-centered optimization of mammography services.

Systematically measuring women's experiences using PREMs help identify practical improvement targets, such as communication quality, workflow design, and timely result disclosure, that may enhance patient satisfaction, reduce anxiety, and potentially increase adherence to breast cancer imaging recommendations.