Mammography-related anxiety: effect of preprocedural patient education.

OBJECTIVES: To determine the effect of preprocedural education on mammography-related anxiety. MATERIALS AND METHODS: A total of 613 women undergoing mammography were surveyed regarding anxiety about the procedure and expected results. Half the study population watched an educational videotape and half watched an entertaining movie in the waiting room. RESULTS: Anxiety levels about results were significantly higher than anxiety levels about the procedure (P <.001). There was no difference in procedural or cancer anxiety levels among women shown the educational tape and those shown the entertaining movie. CONCLUSION: The fear of discovering breast cancer generates most of mammography-related anxiety. Preprocedural education did not affect procedural or cancer-related anxiety.

Effectiveness of resident-prepared conferences in teaching imaging utilization guidelines to radiology residents.

RATIONALE AND OBJECTIVES: The authors evaluated the effectiveness of a resident-prepared conference series for teaching imaging utilization guidelines to radiology residents. MATERIALS AND METHODS: Brown University radiology residents (n = 17) gave 61 presentations on imaging utilization to their colleagues during 16 1-hour conferences. The residents were later examined on the topics presented and surveyed about their familiarity with the American College of Radiology appropriateness criteria, their exposure to issues of cost-effectiveness, and their degree of confidence in providing imaging consultation. The same examination and survey were administered to control residents from the University of Wisconsin (n = 14) and the Oregon Health Sciences University (n = 14). Scores were compared by using linear regression and Wilcoxon rank sum tests. RESULTS: Controlling for years in radiology residency, residents at Brown scored on average 16.0% (standard error = 2.2%) higher than residents at the other universities (P < .001). Controlling for institution, 3rd- and 4th-year residents scored on average 7.4% (standard error = 2.1%) higher than 1st- and 2nd-year residents (P = .001). Brown residents expressed more familiarity with American College of Radiology appropriateness criteria and appeared to have more exposure to cost-effectiveness issues in conferences than residents at Wisconsin or Oregon Health Sciences University (P < .005). Residents from the three universities did not differ in their level of confidence in providing imaging consultation. CONCLUSION: Resident-prepared conferences are an effective means of teaching imaging utilization guidelines to residents, but they do not affect the residents' perception of their ability to provide imaging consultation.

Cost-effectiveness of stereotactic core needle biopsy: analysis by means of mammographic findings.

PURPOSE: To determine the cost savings of stereotactic core needle biopsy over open surgical biopsy in patient subgroups defined according to mammographic findings. MATERIALS AND METHODS: From July 1992 through February 1995, stereotactic core needle biopsy was performed in 356 women with 405 nonpalpable breast lesions (254 were masses and 151 were calcification). Lesions were classified according to mammographic finding, size, and level of suspicion. Two hundred three lesions were classified as indeterminate, 166 as suspicious, and 36 as highly suspicious. Medicare reimbursements for 1995 were used to determine costs and cost savings. RESULTS: Overall cost savings for stereotactic core biopsy over open surgical biopsy was $741 per case. Average cost savings per case was $807 for masses and $630 for calcifications. The greatest savings occurred in the cases of indeterminate masses, with an average of $856 saved per case. The least savings occurred in the cases of highly suspicious calcifications, with $446 saved per case. CONCLUSION: Cost savings of stereotactic core needle biopsy vary in subgroups of patients defined according to mammographic findings. Over-all savings will depend on the distribution of patients among these groups. In this series, cost savings were realized with stereotactic core biopsy over open surgical biopsy for all mammographic subgroups.

Stereotaxic core needle biopsy of breast microcalcifications: correlation of target accuracy and diagnosis with lesion size.

PURPOSE: To determine if lesion size or number of calcifications affects the ability to obtain microcalcifications or a specific histologic diagnosis at stereotaxic core needle biopsy (SCNB). MATERIALS AND METHODS: Mammographic findings and histopathologic reports of 138 lesions in 124 patients (aged 30-87 years; mean age, 56.2 years) who underwent SCNB of calcifications were reviewed. Calcifications in the specimen and attainment of a specific diagnosis were correlated with lesion size and number of calcifications. RESULTS: Calcifications were obtained in 118 cases (86%). A specific diagnosis was reported in 72 cases (52%). Differences in retrieval of calcifications or ability to establish a specific diagnosis with decreasing lesion size or decreasing number of calcifications were not statistically significant. Attainment of a specific diagnosis was significantly related to retrieval of calcifications (P<.005). CONCLUSION: SCNB was successful in obtaining calcifications in a high percentage of cases regardless of lesion size or number of calcifications. When calcifications were retrieved, a specific diagnosis was attained in most cases (72 of 118).