ABSTRACT
BACKGROUND
Little is known about older women’s experience with a benign breast biopsy.
OBJECTIVES
To examine the psychological impact and experience of women ≥ 65 years of age with a benign breast biopsy.
DESIGN
Prospective cohort study using quantitative and qualitative methods.
SETTING
Three Boston-based breast imaging centers.
PARTICIPANTS
Ninety-four English-speaking women ≥ 65 years without dementia referred for breast biopsy as a result of an abnormal mammogram, not aware of their biopsy results at baseline, and with a subsequent negative biopsy.
MEASUREMENTS
We interviewed women at the time of breast biopsy (before women knew their results) and 6 months post-biopsy. At both interviews, participants completed the validated negative psychological consequences of screening mammography questionnaire (PCQ, scores range from 0 to 36 [high distress], PCQ ≥ 1 suggests a psychological consequence, PCQs <1 are reported at time of screening) and women responded to open-ended questions about their experience. At follow-up, participants described the quality of information received after their benign breast biopsy. We used a linear mixed effects model to examine if PCQs declined over time. We also reviewed participants’ open-ended comments for themes.
RESULTS
Overall, 88 % (83/94) of participants were non-Hispanic white and 33 % (31/94) had a high-school degree or less. At biopsy, 76 % (71/94) reported negative psychological consequences from their biopsy compared to 39 % (37/94) at follow-up (p < 0.01). In open-ended comments, participants noted the anxiety (29 %, 27/94) and discomfort (28 %, 26/94) experienced at biopsy (especially from positioning on the biopsy table). Participants requested more information to prepare for a biopsy and to interpret their negative results. Forty-four percent (39/89) reported at least a little anxiety about future mammograms.
CONCLUSIONS
The high psychological burden of a benign breast biopsy among older women significantly diminishes with time but does not completely resolve. To reduce this burden, older women need more information about undergoing a breast biopsy.
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Acknowledgements
We are grateful to Rossana Valencia, MPH, Christine Gordon, MPH, and Maria Cecilia Griggs, RN, MPH, for their work recruiting patients to this study. We are also grateful to Elena Morozov at Beth Israel Deaconess Medical Center, and Julie Ferragamo and Jane Pietrantonio at Brigham and Women’s Hospital for hel** us to identify patients for this study. Written permission has been obtained from all persons named in this acknowledgment. Dr. Schonberg had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr. Mara Schonberg was supported by a Paul B. Beeson Career Development Award in Aging supported by the National Institute on Aging K23 [K23AG028584], the John A. Hartford Foundation, the Atlantic Philanthropies, the Starr Foundation, and the American Federation for Aging Research. Dr. Ngo received support from Harvard Catalyst, the Harvard Clinical and Translational Science Center (NIH Award #UL1 RR 025758 and financial contributions from Harvard University and its affiliated academic health care centers). Dr. Marcantonio was supported by a Midcareer Investigator Award in Patient-Oriented Research from the National Institute on Aging (K24 AG035075). The sponsors had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
Presentations
This work was presented in part at the Presidential poster session of the 2014 annual meeting of the American Geriatrics Society, 15 May 2014. This work was also presented at the 2014 annual meeting of the New England Region of the Society of General Internal Medicine, 7 March 2014.
Conflict of Interest
Dr. Fein-Zachary worked as a consultant for Siemens Medical Solutions USA, Inc., in 2014. All other authors declare that they do not have a conflict of interest.
Financial Disclosure Information
This research was supported by a Paul B. Beeson Career Development Award in Aging supported by the National Institute on Aging K23 [K23AG028584], the John A. Hartford Foundation, the Atlantic Philanthropies, the Starr Foundation, and the American Federation for Aging Research. Dr. Marcantonio was supported by a Midcareer Investigator Award in Patient-Oriented Research from the National Institute on Aging (K24 AG035075).
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Schonberg, M.A., Silliman, R.A., Ngo, L.H. et al. Older Women’s Experience with a Benign Breast Biopsy—A Mixed Methods Study. J GEN INTERN MED 29, 1631–1640 (2014). https://doi.org/10.1007/s11606-014-2981-z
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DOI: https://doi.org/10.1007/s11606-014-2981-z