Our study showed a positive impact of reduced wait times in at least 48% of patients who demonstrated improvement in their screening experience with same day appointment results but this was not shown to be statistically significant. Additionally, 47% patients showed no difference in their experience. About 5% of the patients were less satisfied with the same appointment results, which may be related to multiple factors such as patient expectations, longer than expected wait times, lack of understanding of clinic workflow and feeling pressured into waiting for result during the same appointment with not understanding their choice to reject the proposal. Of the 185 patients who filled our survey, over 154 (83.2%) patients received their results in under 30 minutes after the mammogram and majority of the remaining patients received results in under 45 minutes which is conceivable in our clinic workflow experience. However, 4 patients (2.2%) reported waiting time longer than an hour which may be due to the patient considering wait time starting from the time to check-in, getting the screening mammogram exam, to waiting for the results.
Willingness to return to our breast imaging center next year for a screening mammogram acted as an important assessment tool indicating that our service of same appointment results was well received by our patients with 96.7% of the patients wanting to return for future screening for same appointment results. It was also remarkable that 96.7% responded in favor of recommending our same appointment results service to their family and friends. Additionally, only 31 (16.7%) patients indicated their preference of being notified of their results over phone as opposed to 153 (82.7%) patients showing preference to receiving results in person than over phone. Thus, in our experience patients preferred results in person over results via phone or mail, making screening a more personable and pleasant experience for our patients. In a previous study by our group, it was evident that patients preferred results either during the same appointment or within 48 hours of the screening appointment through a follow up appointment or over the telephone being the most desirable methods (19).
Breast cancer screening can be a stressful experience for women in having to wait several days or even weeks to know the results of their screening mammogram. Sometimes, a screening mammogram result may require a recall visit for additional imaging that could take days or weeks until the patient can get their diagnostic work-up (13, 14). The anxiety and fear, compounded with the uncertainty and prolonged wait times, makes screening mammography an unpleasant experience which effects patient compliance rates (15). Multiple factors can further delay the breast cancer screening in different settings such as physician recommendation, lack of same-day mammography availability, lack of weekend and evening appointments for working women, lower mammography capacity of the clinics, limited notification methods, with majority of patients receiving results via mail within 30 days as per Mammography Quality Standards Act (MQSA) guidelines (16, 17, 18).
In a controlled trial previously done which studied the impact the availability of same day screening mammography had on patients, it was reported that same-day mammography effectively increased the adherence to breast cancer screening recommendations among women aged 50 years or older and improved patient satisfaction (17). Thus, it was again demonstrated that factors reducing the diagnostic interval have often been associated with better patient satisfaction rates in all cancer screening, reducing psychological distress and anxiety among the patients.
The probability of a patient returning for rescreening after a negative mammogram is directly related to their initial screening experience with increasing number of women avoiding rescreening if they feel dissatisfied with the service provided by the staff, longer wait times, inability to schedule appointments at a convenient time and embarrassment going through the screening (20). Breast cancer is now the most commonly diagnosed cancer as per 2020 cancer statistics and early screening is essential to detect it in early stages to reduce mortality. It can be achieved with simple steps that make breast cancer screening a less cumbersome and a patient-oriented personalized experience.
While this study showed that 48% of patient had improvement in their screening experience with same day appointment results, there were still limitations to our study. First, patients were expected to rate their satisfaction of screening experience compared to prior appointments, which could have led to recall bias. This could have been mitigated by having a control group vs those who were randomized to partake in same day appointment results. Additionally, not having a randomized control group could have subject our study to selection bias as to who voluntarily participated in same day appointment results. Lastly, our study was conducted at a single center which may make so that our data is not necessarily representative of other patient populations.