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The clinical issue
Breast cancer screening, such as getting a mammogram, plays an important public health role in improving health outcomes for women, and has contributed substantially to the national and statewide declines in breast cancer mortality over the past 30 years.
Increasingly, organizations like the United States Preventive Services Task Force (USPSTF) are recommending shared decision making between patients and their health care providers as the optimal method for determining whether and how often to screen for breast cancer using mammography. This is particularly true for average risk women.
In order for primary care providers to be able to achieve true shared decision making about breast cancer screening as mandated by the USPSTF, they need information and guidance on how best to approach the shared decision making process when discussing breast cancer screening with their patients.
This toolkit will enable clinicians to engage more effectively with patients when discussing breast cancer screening.
It includes breast cancer screening resources for both clinicians and patients, materials to support shared decision making, and information about an interactive breast cancer screening decision aid.
Who should use this toolkit?
This toolkit is intended for primary care providers who engage in discussion with average risk women regarding breast cancer screening.
The toolkit can also be used by health care administrators who are interested in increasing shared decision making about breast cancer screening within their organizations.
What does the toolkit contain?
This toolkit includes resources and supporting materials that offer health care providers information about topics such as breast cancer risk factors and assessment, shared decision making principles, and benefits and harms of breast cancer screening.
Multimedia information is also included to demonstrate how to use a breast cancer screening decision tool in a primary care encounter, along with patient education materials to be used as supplementary materials with the breast cancer screening decision aid.
How should these tools be used?
Clinicians can use the toolkit resources to:
- Guide utilization of a breast cancer screening decision aid in a primary care encounter
- Print educational materials for average risk women who present in clinic to talk about breast care screening
- Supplement patient-provider discussions about breast cancer screening
Development of this toolkit
The Breast Cancer Screening Shared Decision Making Toolkit was developed by researchers and health care providers (Principal Investigator: Sarina Schrager, MD, MS) at the University of Wisconsin-Madison School of Medicine & Public Health.
This project was supported by the University of Wisconsin School of Medicine and Public Health’s Health Innovation Program (HIP), the Wisconsin Partnership Program, and the Community-Academic Partnerships core of the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR), grant 9 U54 TR000021 from the National Center for Advancing Translational Sciences (previously grant 1 UL1 RR025011 from the National Center for Research Resources), the National Cancer Institute through grant K24 CA194251, and the University of Wisconsin Carbone Cancer Center, support grant P30 CA014520 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other funders.
We thank Gina Phillips for her contribution to the development of the patient education materials in this toolkit.
Please send questions, comments and suggestions to HIPxChange@hip.wisc.edu
References
- Burnside ES, Schrager S, DuBenske L, Keevil J, Little T, Trentham-Dietz A, Rolland B, Shah D, Alagoz O. Team Science Principles Enhance Cancer Care Delivery Quality Improvement: Interdisciplinary Implementation of Breast Cancer Screening Shared Decision Making. JCO Oncol Pract. 2023 Jan;19(1):e1-e7.
- Schrager SB, Phillips G, Burnside E. A Simple Approach to Shared Decision Making in Cancer Screening. Fam Pract Manag. 2017 May/Jun;24(3):5-10.
Toolkit citation
Schrager S, Little T. “Breast Cancer Screening Shared Decision Making Toolkit.” University of Wisconsin-Madison School of Medicine & Public Health. Madison, WI; 2018. Available at: https://www.hipxchange.org/ScreeningMammo.
About the Authors
Sarina Schrager, MD, MS is a Professor in the University of Wisconsin – Madison Department of Family Medicine and Community Health. As a primary care physician with a specialty in women’s health, she has been providing care for women in her clinical practice for over 20 years. Her current work focuses on designing and implementing approaches that promote patient centered care and the advancement of shared decision making in cancer screening. She is committed to helping patients make decisions that align with their values, preferences and goals.
Terry Little, MS was an Administrative Program Specialist in the University of Wisconsin – Madison Department of Radiology. She has worked closely with UW researchers in the development and implementation of an Electronic Health Record (EHR) embedded breast cancer screening decision aid to improve breast health care for women in Wisconsin. She also has experience planning, coordinating, and facilitating patient and provider engagement in research.
