by Robert Calvert, DO
As family medicine residents and attending physicians, we are often faced with the challenging task of explaining conflicting guidelines regarding breast cancer screening to our patients. With various organizations and expert groups providing differing recommendations, it can be perplexing for both healthcare providers and patients alike.
Breast cancer screening guidelines have evolved over time as new evidence emerges, leading to differences in recommendations from organizations such as the American Cancer Society (ACS), the U.S. Preventive Services Task Force (USPSTF), and the American College of Obstetricians and Gynecologists (ACOG). These disparities often arise from variations in the interpretation of research findings, the balance between benefits and harms, and the prioritization of resources.
These are likely to continue to change as shown by the new draft recommendation for breast cancer screening from USPSTF released in May 2023. Consequently, it is crucial for family medicine physicians to stay updated on the latest guidelines and be prepared to address patient concerns and uncertainties.
Effective Communication Strategies
- Educate patients about the variability: Begin by explaining that different organizations may have varying perspectives on breast cancer screening due to differences in evidence interpretation. Emphasize that guidelines are based on overall population-based risks and benefits and may not precisely apply to each individual.
- Encourage shared decision-making: Empower patients to participate actively in the decision-making process. Present the various guidelines, discuss their rationale, and provide the patient with an opportunity to express their preferences.
- Discuss individual risk factors: Assessing a patient’s individual risk for breast cancer can guide the decision-making process. Factors such as age, family history, genetic predisposition, and personal health history should be taken into account. Explain how these factors may influence the screening recommendations and provide personalized guidance accordingly.
- Emphasize the importance of informed consent: Clarify the benefits and potential harms of breast cancer screening, including false positives, overdiagnosis, and unnecessary interventions.
- Regularly update knowledge: Stay abreast (pun intended) of the latest research and guidelines in breast cancer screening. Ensure your knowledge is up-to-date to allow you to provide the most accurate and evidence-based information to your patients.
Addressing conflicting breast cancer screening guidelines can be challenging for family medicine physicians. By employing effective communication strategies, focusing on shared decision-making, and considering individual risk factors, we can help patients navigate through the complex landscape of guidelines. Open dialogue and patient-centered care are key to empowering individuals to make informed decisions about their breast health. In the face of ongoing research and evolving guidelines, it is essential to stay updated and maintain a patient-centric approach in order to provide the best possible care to our patients.
Dr. Calvert grew up here in Salt Lake City, UT and obtained his undergraduate degree at the University of Utah. He completed medical school at Western University of Health Sciences College of Osteopathic Medicine of the Pacific in Pomona, CA. Dr. Calvert began his medical career as a Navy medical officer, completing internship at Naval Hospital Camp Pendleton. He served as a Flight Surgeon at Naval Aviation Warfighting Development Center in Fallon, NV taking care of active duty service members. He chose to return to the University of Utah due to excellent faculty mentors, supportive residents, and the unique blend of community and university family medicine training. Dr. Calvert is passionate about patient engagement, outpatient procedures, and acne treatment. His interests include hiking, skiing, mountain biking, birdwatching, and dancing with his daughters.
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