Acceptability of a companion patient guide to support expert consensus guidelines on surveillance mammography in older breast cancer survivors

Rachel A. Freedman, Anna C. Revette, Haley Gagnon, Adriana Perilla-Glen, Molly Kokoski, Saida O. Hussein, Erin Leone, Nicole Hixon, Rebeka Lovato, Wendy Loeser, Nancy U. Lin, Christina A. Minami, Beverly Canin, Barbara LeStage, Meredith Faggen, Philip D. Poorvu, Jennifer McKenna, Kathryn J. Ruddy, Nancy L. Keating, Mara A. Schonberg

Research output: Contribution to journalArticlepeer-review


Purpose: To support shared decision-making, patient-facing resources are needed to complement recently published guidelines on approaches for surveillance mammography in breast cancer survivors aged ≥ 75 or with < 10-year life expectancy. We created a patient guide to facilitate discussions about surveillance mammography in older breast cancer survivors. Methods: The “Are Mammograms Still Right for Me?” guide estimates future ipsilateral and contralateral breast (in-breast) cancer risks, general health, and the potential benefits/harms of mammography, with prompts for discussion. We conducted in-clinic acceptability testing of the guide by survivors and their clinicians at a National Cancer Institute-designated comprehensive cancer center, including two community practices. Patients and clinicians received the guide ahead of a clinic visit and surveyed patients (pre-/post-visit) and clinicians (post-visit). Acceptability was defined as ≥ 75% of patients and clinicians reporting that the guide (a) should be recommended to others, (b) is clear, (c) is helpful, and (d) contains a suitable amount of information. We also elicited feedback on usability and mammography intentions. Results: We enrolled 45 patients and their 21 clinicians. Among those responding in post-visit surveys, 33/37 (89%) patients and 15/16 (94%) clinicians would recommend the guide to others; 33/37 (89%) patients and 15/16 (94%) clinicians felt everything/most things were clear. All other pre-specified acceptability criteria were met. Most patients reported strong intentions for mammography (100% pre-visit, 98% post-visit). Conclusion: Oncology clinicians and older breast cancer survivors found a guide to inform mammography decision-making acceptable and clear. A multisite clinical trial is needed to assess the guide’s impact mammography utilization. Trial registration:, posted March 7, 2019.

Original languageEnglish (US)
Pages (from-to)141-152
Number of pages12
JournalBreast Cancer Research and Treatment
Issue number2
StatePublished - Sep 2022


  • Decision-making
  • Guide
  • Mammogram
  • Mammography
  • Older breast cancer survivors

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


Dive into the research topics of 'Acceptability of a companion patient guide to support expert consensus guidelines on surveillance mammography in older breast cancer survivors'. Together they form a unique fingerprint.

Cite this