By Aine Cryts
Conflicting screening guidelines for breast cancer can lead to confusion for referring physicians, radiologists, and patients. The American College of Radiology (ACR) points to a study that shows annual breast cancer screenings greatly reduce a woman’s chances of dying due to breast cancer. Despite this fact, 35% of women who should get screened choose to forgo a mammogram—and that contributes to thousands of deaths each year.
That’s why ACR recently launched a CME toolkit called “Talking to Patients About Breast Cancer Screening.” Available in online and printable formats, the materials can be customized with a logo from a radiology group or hospital.
Included in the toolkit are links to videos that educate patients on what to expect when having a mammogram and explainers on breast cancer screening risks and understanding breast cancer over-diagnosis.
AXIS Imaging News recently asked Dana Smetherman, MD, MPH, chair of ACR’s commission on breast imaging, about the organization’s breast cancer screening toolkit. Smetherman is also chair of the department of radiology at Ochsner Medical Center-New Orleans. Here’s what she had to say.
AXIS Imaging News: Why did ACR develop this toolkit?
Dana Smetherman: The ACR developed this toolkit in response to requests from our members, patients, and colleagues in other specialties to better understand the data and science behind the screening mammogram recommendations of the ACR, Society of Breast Imaging, and the American Society of Breast Surgeons—namely, that annual mammography beginning at age 40 for women of average risk will result in a much greater reduction in the risk of dying from breast cancer, many more lives saved, and less aggressive treatment options (fewer mastectomies and less need for chemotherapy) than guidelines that advocate starting later or having mammograms less frequently.
We hoped to make it easy for everyone—healthcare providers and patients—to find this information. In addition, we wanted to put the data in different formats that would be readily understood by all of our audiences, both healthcare providers and patients.
AXIS: Why did you decide to develop a free CME to support this effort?
Smetherman: ACR’s goal is to encourage radiologists and referring clinicians to use these materials. Our hope was that offering CME might further encourage physicians to learn more about the toolkits, since all physicians are required to obtain CME on a regular basis for maintenance of licensure and, in some cases, accreditation and certification.
AXIS: Who was involved in the development of this toolkit? Breast cancer specialists? Others?
Smetherman: We were fortunate to be able to draw on the expertise of a large number of radiologists from across the United States with expertise not only in breast cancer detection, diagnosis, and treatment, but also breast cancer screening. In addition, we were lucky to have the support and resources of ACR and its wonderful staff to make this project a reality.
We also worked hard to ensure that the content would be understandable to both individuals with a healthcare background—including radiologists and other healthcare providers—and to patients. Another priority was easy accessibility, so we ensured the materials were easy to download and print.
AXIS: How should radiologists use this toolkit?
Smetherman: I’d encourage radiologists to download and review the materials, so they become familiar with the content and feel comfortable sharing these statistics with their patients and colleagues in other specialties, including primary care. In addition, we want radiologists to really embrace these products and incorporate them into their practices, perhaps by putting printed versions in their waiting rooms for patients to read and links to this information on their websites.
We’ve been excited to learn that many radiology practices and ACR chapters are already using the materials, both displaying printed copies in their facilities and using this information in their correspondence and other communications with referring providers and patients. We hope that allowing practices and other organizations to customize the tools with their own branding and making toolkits and other materials available free of charge will also foster widespread use.
AXIS: How should practice administrators use this toolkit?
Smetherman: It’s very important that every member of the healthcare team—administrators, technologists, nurses, advance-practice providers, and physicians—understands the research that shows beginning screening mammography at age 40 and continuing annually saves the most lives. We’d definitely miss an opportunity if we focused our efforts only on physicians.
The toolkits are readily available in printed and digital format, and it would be great if practice administrators incorporated these materials and this information in their work with patients and referring physicians’ offices.
AXIS: There’s a lack of clarity among women, their primary-care physicians, and radiologists concerning when a woman should receive a mammogram. What is the takeaway for radiology practices and other decision-makers?
Smetherman: We can’t ignore the fact that lives could be saved if more patients and healthcare providers understood this data. As is noted in the toolkits, the 40% reduction in the risk of dying from breast cancer with yearly mammography beginning at 40 years of age shrinks to 23% when women have mammograms only every other year from 50 years of age to 74 years or age, and the number of lives saved (per 100,000 women) decreases from 1,190 to only 695.
Aine Cryts is a contributing writer for AXIS Imaging News.