• Mara A Schonberg, Rebecca A Silliman, Long H Ngo, Robyn L Birdwell, Valerie Fein-Zachary, Jessica Donato, and Edward R Marcantonio.
• Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA, mschonbe@bidmc.harvard.edu.
• J Gen Intern Med. 2014 Dec 1; 29 (12): 1631-40.

BackgroundLittle is known about older women's experience with a benign breast biopsy.ObjectivesTo examine the psychological impact and experience of women ≥ 65 years of age with a benign breast biopsy.DesignProspective cohort study using quantitative and qualitative methods.SettingThree Boston-based breast imaging centers.ParticipantsNinety-four English-speaking women ≥ 65 years without dementia referred for breast biopsy as a result of an abnormal mammogram, not aware of their biopsy results at baseline, and with a subsequent negative biopsy.MeasurementsWe interviewed women at the time of breast biopsy (before women knew their results) and 6 months post-biopsy. At both interviews, participants completed the validated negative psychological consequences of screening mammography questionnaire (PCQ, scores range from 0 to 36 [high distress], PCQ ≥ 1 suggests a psychological consequence, PCQs <1 are reported at time of screening) and women responded to open-ended questions about their experience. At follow-up, participants described the quality of information received after their benign breast biopsy. We used a linear mixed effects model to examine if PCQs declined over time. We also reviewed participants' open-ended comments for themes.ResultsOverall, 88% (83/94) of participants were non-Hispanic white and 33% (31/94) had a high-school degree or less. At biopsy, 76% (71/94) reported negative psychological consequences from their biopsy compared to 39% (37/94) at follow-up (p < 0.01). In open-ended comments, participants noted the anxiety (29%, 27/94) and discomfort (28%, 26/94) experienced at biopsy (especially from positioning on the biopsy table). Participants requested more information to prepare for a biopsy and to interpret their negative results. Forty-four percent (39/89) reported at least a little anxiety about future mammograms.ConclusionsThe high psychological burden of a benign breast biopsy among older women significantly diminishes with time but does not completely resolve. To reduce this burden, older women need more information about undergoing a breast biopsy.

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