Physicians' perceptions of breast density notification laws and appropriate patient follow-up
Physicians' perceptions of breast density notification laws and appropriate patient follow-up
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DOI：
10.1111/tbj.14240
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发表时间：
2021-05-14
期刊：
影响因子：
2.1
通讯作者：
Purrington, Kristen
中科院分区：
文献类型：
--
作者：
Manning, Mark;O'Neill, Suzanne;Purrington, Kristen
在没有一致的通知后后续行动准则的情况下，通过了乳房密度通知法。由于医生的做法不一致，这可能导致对妇女健康的管理不一致和可能有缺陷。我们检查了医生的知识和做法，对后续的病人谁收到密度通知。将患者转诊至密歇根州医院网络进行筛查乳房X线照片的医生被招募参加调查研究; 105人（29.8%）做出回应。该调查评估了医生的人口统计学，知识，乳腺密度和乳腺癌风险的认识和密度通知法律，以及对接受密度通知的患者的适当随访行为的看法。大多数医生（75%）知道通知法，他们通常很乐意回答乳腺密度问题并决定随访。大多数人表示，额外的乳腺成像（68.0%），其次是评估乳腺癌风险（24.7%）是适当的随访反应。进行乳腺癌风险评估的医生，以及对乳腺密度问题和后续决策更满意的医生，更有可能提出额外的成像。男性医生不太可能提出评估乳腺癌风险，也不太可能提出临床和/或乳房自我检查。在补充乳腺癌筛查方面，实践和指南之间的分歧，加上在缺乏一致证据的情况下促进额外筛查的密度通知语言，仍然令人担忧。更好地了解密度通知接收者及其医生如何做出关于补充筛查的决定，以确保适当考虑乳腺癌风险。
Breast density notification laws have been adopted in the absence of consistent guidelines for post-notification follow-up. This can lead to inconsistent and potentially deficient management of women's health due to inconsistent physician practices. We examined physicians' knowledge and practices regarding follow-up for patients who receive density notifications. Physicians who referred patients to a Michigan hospital network for screening mammograms were recruited to participate in survey study; 105 (29.8%) responded. The survey assessed physicians' demographics, knowledge, and awareness of breast density and breast cancer risk and of density notification laws, and perceptions of appropriate follow-up behaviors for their patients who received density notifications. Most physicians (75%) knew about the notification law, and they were generally comfortable responding to breast density questions and deciding on follow-up. Most indicated that additional breast imaging (68.0%), followed by assessing breast cancer risk (24.7%) were appropriate follow-up responses. Physicians who performed breast cancer risk assessments, and who were more comfortable with breast density questions and follow-up decision making, were more likely to propose additional imaging. Male physicians were less likely to propose assessing breast cancer risk, and less likely to propose clinical and/or breast self-examinations. Divergence between practice and guidelines when it comes to supplemental breast cancer screening, coupled with density notification language that promotes additional screening in the absence of consistent evidence, remains concerning. Improved understanding of how density notification recipients and their physicians make decisions about supplemental screening is warranted to ensure that breast cancer risk is properly considered.