Assessing Preparedness of Primary Care Physicians to Discuss the Breast Biopsy Process and Results after Abnormal Mammograms: A Cross-Sectional Survey

Abstract

Objective:

Abnormal mammography results can contribute to anxiety for women, and primary care physicians (PCPs) are responsible for discussing these results with women. We sought to examine PCPs’ preparedness to discuss the breast biopsy process and biopsy results with women who have received an abnormal mammogram result and the physician, practice, panel, and communication factors associated with that preparedness.

Methods:

Cross-sectional analysis of internal medicine and family medicine PCPs in San Francisco, CA. We used multivariable logistic regression to examine the associations.

Results:

Of the 588 PCPs invited, 300 (51%) completed the survey. Seventy-three percent of respondents (n = 219) felt equipped to explain a core biopsy, but only 40% of PCPs (n = 120) felt that they had the expertise to answer questions from women about breast biopsy results. Family medicine training, private practice setting, greater percentage of panel of older patients, and viewing the ordering physician (versus radiologist) as primarily responsible for notifying patients of abnormal results were positively associated with feeling equipped to explain the biopsy process. Challenges in communication due to cultural differences between PCP and patient were negatively associated with a physician’s sense of expertise to answer questions about biopsy results.

Conclusions:

PCPs reported having the expertise to discuss the results of breast biopsies with women less frequently than they reported feeling equipped to discuss the breast biopsy process. Greater uncertainty was observed when PCPs were communicating with women from different cultural backgrounds from their own.