Routine screening mammograms are often recommended for women beginning at age 40, but primary care clinicians are encouraged to inform their patients of the benefits and potential harms of the procedure and to invite them to share in the decision making, according to background information in the article. Previous studies suggest that women overestimate the risk of breast cancer and the benefits of screening and are unaware of possible harm, the authors write. In addition, little is known about how much involvement women want in decision making about initiating screening.

Larissa Nekhlyudov, M.D., M.P.H., of Harvard Medical School, and colleagues surveyed women age 40 to 44 scheduled for their first screening mammogram. Women were asked to rate the importance to them of elements of information about the mammogram and their preferences for involvement in decision making, ranging from making the decision alone to having the decision made by her clinician alone.

Most of the 96 women surveyed preferred their primary care practioner as their main source of information about the screening mammogram. The women were particularly interested in logistical information before their mammogram, such as which steps to take following an abnormal mammogram (89 percent), how they would be contacted (75 percent) and how quickly (71 percent). They were also interested in potential harms, of false-positive results (84 percent) and false-negative results (82 percent). Being informed about the benefits of screening and about breast cancer risk were also rated as important. Information about pain and cost were desired less often.

When asked about their preferences for involv
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Contact: John Lacey
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JAMA and Archives Journals
27-Jun-2005