Evaluating provider knowledge and practices in breast cancer screening: Identifying gaps and barriers to informed referrals

Abstract

Purpose

To evaluate knowledge and practices of primary care providers on high-risk breast cancer screening imaging recommendations.

Methods

A 10-question anonymous survey was distributed via e-mail to primary care providers. The survey assessed provider knowledge of screening guidelines, current referral practices, perceived barriers to timely screening implementation, and preferences in screening methodologies. Responses were aggregated and results reported descriptively.

Results

Response rate was 23.3 % (49/210). Majority 55 % (27/49) were obstetricians or gynecologists, 35 % (17/49) were internal medicine or primary care physicians, and 10 % (5/49) were advanced practice providers from the obstetrics and gynecology and internal medicine departments. Nearly all the respondents reported that they routinely assess patients for breast cancer risk. However, more than a quarter (28 %, 14/49) of respondents disagreed that all women should have their lifetime risk of breast cancer assessed by age 25–30, with those remote from their training more likely to disagree (p < 0.001). There was variability in knowledge of appropriate breast imaging screening exam for those identified as high-risk for developing breast cancer, with MRI (69 %, 34/49), mammography (65 %, 32/49), ultrasound (59 %, 29/49), and genetic testing (55 %, 27/49) all being recommended in close proportions. Multiple barriers to routine cancer risk assessment were identified, with time constraints (20 %, 8/40), cost (18 %, 7/40) and lack of knowledge (18 %, 7/40) of assessment tools most frequently reported.

Conclusion

High-risk breast cancer screening recommendations practice patterns vary among different specialty primary care providers. Lack of time and knowledge were the main barriers for breast cancer risk assessment evaluation. Future interventions should focus on provider education to optimize imaging recommendations.