Physicians at Weill Cornell Medical College and Memorial Sloan Kettering Cancer Center in New York have created a website that provides women aged 40-49 a personalized experience as they try to decide whether to get mammograms.
The site, Breast Screening Decisions, includes a breast cancer risk assessment, information about possible screening mammogram outcomes for women who have similar risk, and the screening options available to them. It also provides women with a summary of their own risk and possible mammogram outcomes, and helps them clarify their concerns and beliefs about screening, especially their tolerance for uncertain screening results and treatment outcomes.
One of the site's creators, Weill Cornell's Margaret Polaneczky, M.D., said the site was inspired by changes in recommendations for screening mammograms for women in the site's target age range: In 2009, the U.S. Preventive Services Task Force released new recommendations that advised against routine screening mammograms for women ages 40-49 a reversal of prior guidelines.
The panel instead advised women in their 40s to make individual decisions about screening mammography in collaboration with their physicians and in the context of their personal breast cancer risk, values and preferences. Not all medical professional organizations and societies agreed. The conflicting advice stoked confusion among both patients and their doctors.
"If I was confused, I suspected my patients were, too," Polaneczky said. "I had to do a lot of digging to find out why in the world someone would want to do anything but an annual mammogram."
While the website poses a series of questions to help women explore their values, it doesn't dictate how their feelings should factor into the decisions they make. Polaneczky said that design factor was intentional.
"This is individual. This is about you figuring out what's important to you, not what your girlfriends are doing," she said. Eventually, the site may include a social media component so women can see what other people in their risk groups are doing.
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