© 2004 by Oxford University Press
© 2004 Oxford University Press
CORRESPONDENCE |
RESPONSE: Re: Decreasing Women’s Anxieties After Abnormal Mammograms: A Controlled Trial
Affiliation of authors: Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, Boston, MA
Correspondence to: Mary B. Barton, MD, MPP, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Ave., 6th Floor, Boston, MA 02215 (e-mail: mary_barton{at}hms.harvard.edu)
Dr. Kopans suggests that immediate reading of mammograms is fraught with problems and that "double reading of mammograms is not feasible when immediate mammogram interpretations are provided." We strongly disagree that this combination is not feasible because exactly this combination is routinely carried out in our clinical setting and took place during our study, as we described in our article (1). Our patients therefore were not deprived of the benefits he describes for double reading.
We agree with Dr. Kopans that education of women is important—so much so that we designed an educational intervention to do exactly that and studied its effects on women’s anxiety because we feel that it is important to determine if well-meaning, well-designed educational efforts are effective rather than just assuming that they are. Unfortunately, the educational intervention was not associated with decreased anxiety among women with false-positive mammograms (1). Meanwhile, we found that immediate reading of mammograms did decrease anxiety (1).
Dr. Kopans wondered how the level of anxiety associated with breast cancer screening compared with that associated with other types of screening. Although our study was not designed to investigate this issue, our clinical experience suggests that false-positive mammograms cause substantially more anxiety than do false-positive results from other common screening tests that women undergo. Finally, we share Dr. Kopans’s concerns about the increasing amount of stress experienced by mammographers and the potential negative impact that additional burdens placed on mammographers might have on the availability of breast cancer screening. Effective and efficient solutions for reducing these burdens need to be found.
REFERENCE
1 Barton MB, Morley DS, Moore S, Allen JD, Kleinman KP, Emmons KM, et al. Decreasing women’s anxieties after abnormal mammograms: a controlled trial. J Natl Cancer Inst 2004;96:529–38.
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J Natl Cancer Inst 2004 96: 1186-1187.
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