BACKGROUND: Screening mammography for women 50 to 69 years of age may lead to 50% having an abnormal study. We set out to determine the
proportion of women who understand their abnormal mammogram results and the factors that predict understanding.
METHODS: We surveyed 970 women age 40 to 80 years identified with abnormal mammograms from 4 clinical sites. We collected information
on demographic factors, language of interview, consultation with a primary care physician, receipt of follow-up tests, and
method of notification of index mammogram result. This study examines the following outcomes: the participant’s report of
understanding of her physician’s explanation of results of the index mammogram, and a comparison of the radiology report to
the participant’s report of her index mammogram result. Multivariate models controlled for age, education, income, insurance
status, and clinical site.
RESULTS: The majority (70%) reported a “full understanding” of their physician’s explanation of their abnormal mammogram, but a significant
minority (30%) reported less than a full understanding (somewhat, not at all, did not explain). Among women of Asian ethnicity,
only 63% reported full understanding. Asian ethnicity was a negative predictor (odds ratio [OR], 0.4; 95% confidence interval
[CI], 0.3 to 0.7), and consultation with a primary care physician was a positive predictor (OR, 2.3; 95% CI, 1.7 to 3.3) of
reported full understanding. Of the 304 women with a suspicious abnormality, only 51% understood their result to be abnormal.
Women notified in person or by telephone were more likely than women notified in writing to understand their result to be
abnormal (OR, 2.3; 95% CI, 1.2 to 4.8).
CONCLUSION: Almost half of women with the most suspicious mammograms did not understand that their results was abnormal. Our data suggest
that direct communication with a clinician in person or by phone improves comprehension.
Key words abnormal mammography - patient-doctor communication - ethnicity - language barriers - communication barriers
These results were presented in part at the Society of General Internal Medicine annual meeting, Vancouver, Canada, May 2003.
See editorial by Chin, p. 448.
This study was supported through a grant from the National Cancer Institute, NIH grant 1 PO1 CA55112-05A1 to the Northern
California Cancer Center, National Cancer Institute grant from the Special Population Network program to Baylor College of
Medicine (Redes En Acción U01CA86117), grant P30-AG15272 under the Resource Centers for Minority Aging Research program by
the National Institute on Aging, National Institute of Nursing Research, and the National Cente or Minority Health and Health
Disparities, and from Health Resources Services Administration (HRSA) Fellowship Training grant 1 D14 HP 00178-01 in general
internal medicine.