Reassuring words: Communication w/ rads eases anxiety levels during biopsy

Image-guided breast biopsies are stressful events for women, but better communication with the radiologist recommending the procedure seems to lower patient anxiety, according to a study published in the June issue of the Journal of the American College of Radiology.

The study also found differences in anxiety levels were associated with a patient’s race, according to Lauren S. Miller, MD, Riverside Radiology and Interventional Associates, Columbus, Ohio, and colleagues.

“Given that elevated patient anxiety related to breast biopsy can persist for years and has affected screening mammography policy recommendations, these results highlighting the association between better radiologist-patient communication and lower patient anxiety have implications for efforts aimed at improving patient adherence to mammographic screening,” wrote the authors.

Findings were based on questionnaires completed by 138 women who had been recommended for image-guided breast biopsy. Patients were asked about anxiety levels both before and after the procedure, and also about their communication with the radiologist.

On a scale of 20 to 80 points, average prebiopsy anxiety was 44.5, reported the authors. Better communication with the radiologist who recommended the procedure was significantly associated with lower anxiety scores (r= -0.22). Post-biopsy anxiety scores fell to an average of 37.2, and the association between communication and reduced anxiety persisted following the procedure.

White women reported a mean prebiopsy anxiety score of 45.98, compared with 40.43 for nonwhite women. This racial gap in anxiety was also present post-biopsy. “This suggests that white women either need greater emotional and psychological support throughout the biopsy process or have a reporting style that leads to higher scores; additional studies would be needed to examine this issue,” wrote Miller and colleagues.

One seemingly contradictory finding was that nonwhite women, despite having lower anxiety levels, also reported lower levels of communication with the radiologist, even though communication is a unique factor contributing to lower patient anxiety. Another surprise reported by the authors was the fact that having the same radiologist both recommend and conduct the biopsy resulted in better communication, but involvement of a single radiologist was not correlated with reduced anxiety.

Miller and colleagues explained the study did not establish a causal relationship, just correlation, and that further research into the effects of patient-radiologist communication is warranted.