Pilot Evaluation of Patient-centered Survey Tools for Breast Cancer Screening Decision-making in Women 75 and Older

Objective: Breast cancer screening recommendations in women >= 75 years of age vary. Studies show harm with over-screening, and limited benefit in mammography for women with short life expectancy; however, many women >= 75 years continue screening. We pilot-tested a validated decision-aid in women >= 75 years to evaluate feasibility of implementation in an internal medicine clinic with secondary objectives to determine if it improved knowledge about mammogram screening recommendations and/or changed intent to screen. Methods: Eligible women were mailed a pre-intervention survey assessing their knowledge of breast cancer and screening. At a routine appointment they were given a decision-aid on yearly screening after age 75. Following this appointment they completed a post-intervention survey. Results: Overall, 28% (N = 16) of eligible participants enrolled, with 8 completing the study. Pre-intervention, all participants planned to get a screening mammogram in the next year; post-intervention, 63% planned to continue screening. Conclusions: Women >= 75 years of age may consider changing their screening schedule based on a decision-aid given at a well-visit appointment. Challenges included a small sample size and need for better recruitment techniques in this population.