If you’re going to have to tell a woman that she has breast cancer, she wants to hear the news as quickly as possible, preferably face to face, ideally within 1-2 days of the biopsy being done, and have an appointment set up to deal with the diagnosis either that day or the next.
That’s what Dr Deanna Attai and colleagues found out when they surveyed over 1000 women, including 784 breast cancer survivors, to find out how and how soon they wanted to get their breast biopsy results, and compared that to what actually happened when they got their results.
It’s no surprise that in almost all cases, when it comes to hearing results, what women got did not match what they wanted. For example, while 40% of women heard their diagnosis within 1-2 days of biopsy, 80% would have wanted their results within that time frame. Fifty four percent heard their mammogram results within 2 days, but 84% wanted them the same or next day.
A few important nuances emerged from the data – given a choice between hearing results face-to-face and getting them faster over the phone, women opt for speed. If it’s a mammogram or blood test result rather than a biopsy, face-to-face is not as important.
Most interesting were the comments women made on their surveys, which should be required reading for anyone having to give bad news. Here are just a few –
- “Use the same compassion and candor you would use if you had to give this info to your loved one”
- “Nothing is worse than calling a patient and telling them to bring someone with them but not telling them why.”
- “Please remember that a bad test result may throw a person off, so much so that they cannot really hear what you are saying. Be clear and be careful. Ask the person to reflect back what you have said, so you are sure they got it!”
- “We were starving for reliable information when I was diagnosed. Wish there was information provided with the results that further explained everything.”
- “Always present situation with hope.”
- “My oncologist was exceptionally kind. He said ‘I’m sorry this is happening to you’. He was the only one of several doctors to do so’”
The study population by design sampled internet-saavy women, and Caucasian women were over-represented in the sample, so these results may not extrapolate to all women.
But the message is loud and clear – when it comes to breast cancer screening results, we are not meeting our patient’s desire for timeliness or preferred method of communication.
I’d wager all women, no matter what race, creed, or color, want empathy and quick results.
It must be a very hard road to walk for a doctor to give results quickly but over the phone vs slower but in person. In person definitely provides advantages to gauging a person’s reaction, providing physical support, and what questions she needs answered or other support. But the request to come back for results also leads most to automatically presume it’s the worst possible news. If the appointment isn’t in the next couple hours, the stress of wondering has it’s own effect. She says as a notorious worry wart who had to get a biopsy last year and couldn’t focus for the 24 hours it took to get the results: fortunately it turned out to be nothing. My doc was great, highly empathetic, and even called to let me know he didn’t know yet when the lab results were late in coming in “which just means the lab is slow today NOT that there’s an issue!” I can’t imagine what a basket case I’d have been if I’d had to wait over the weekend…(I was very fortunate in that I had a mammogram one week, they saw a “strange” spot and asked me to come back in the next week. I did, they did a dozen more scans from various angles, still couldn’t get a good look, decided to do a biopsy, did it, I was out the door an hour from when I walked in and had my results the next day. Dakota Radiology is da bomb.)