Now or Later? Patient Satisfaction and Anxiety Among Women Undergoing Breast Biopsies Performed the Same Day as Recommended Versus a Later Day

PURPOSE

The aim of this study was to determine differences in patient satisfaction and anxiety among women undergoing core-needle breast biopsies performed the same day as recommended versus a future date.

METHODS

After institutional review board exemption was granted, a survey was administered to patients at four sites on the day of imaging-guided core-needle breast biopsy. The survey was available from November 2020 through January 2022. Questions pertained to biopsy timing (same day versus later day), pre- and postbiopsy satisfaction with overall breast-care experience, biopsy wait-time satisfaction, pre- and postbiopsy anxiety, radiologist-patient communication, demographics, life stressors, breast cancer history, and risk factors. Comparisons were made between same-day and later-day biopsies by multivariable analysis.

RESULTS

Of 974 respondents (response rate 65.6%), almost half were scheduled for same-day biopsies (47.8% [466 of 974]). In multivariate analyses, same-day biopsies were associated with higher prebiopsy overall breast-care satisfaction (P < .001), higher wait-time satisfaction (P < .001), and higher prebiopsy (P = .001) and postbiopsy anxiety (P = .001). Better radiologist-patient communication was associated with lower prebiopsy anxiety (P < .001) and greater prebiopsy overall (P < .001) and wait-time (P < .001) satisfaction. Compared with White women, Black women reported lower postbiopsy anxiety (P < .001) but also lower prebiopsy satisfaction (P = .03) and wait-time satisfaction (P < .001).

CONCLUSIONS

Same-day versus later-day biopsies resulted in better prebiopsy overall breast-care and wait-time patient satisfaction scores; however, no satisfaction differences were noted after biopsy. Clinically significant anxiety was associated with both same- and later-day biopsies but was higher for same-day biopsies. Higher anxiety levels correlated with lower overall satisfaction, suggesting that interventions to reduce anxiety and improve communication could improve patient experiences during same-day biopsies.

Impact of a Same-Day Breast Biopsy Program on Disparities in Time to Biopsy

BACKGROUND

Disparities in breast cancer diagnosis are established. In usual practice, biopsies are performed days or weeks after recommendation. Our aim was to measure the impact of a same-day biopsy program on disparities in time from biopsy recommendation to performance.

METHODS

After Institutional Review Board approval, we identified all diagnostic examinations leading to biopsy pre- (September 2016 to March 2017) and post- (September 2017 to March 2018) implementation of our same-day biopsy program. We compared demographic characteristics (age, race, language, and insurance) and biopsy information (days from biopsy recommendation to biopsy, and proportion of same-day biopsies in all biopsies) in pre- versus postimplementation groups. Multivariable linear and logistic models in pre- and postimplementation groups assessed if days from biopsy recommendation to biopsy and having a same-day biopsy were associated with patient subgroups.

RESULTS

In all, 663 and 482 patients underwent biopsy during pre- and postimplementation periods, respectively. Patient subgroups were similar between periods. For all patients, the same-day biopsy program decreased median time from diagnostic examination to biopsy from 8 (interquartile range: 4-13) to 0 (interquartile range: 0-4) days (P < .001). During the pre-implementation period, nonwhite patients and having Medicare insurance were associated with longer days to biopsy (nonwhite Adjusted Coefficient: 2.31, 95% confidence interval [CI]: 0.58-4.03; insurance Adjusted Coefficient: 2.47, 95% CI: 0.58-4.37; P < .05), after adjustment. During the postimplementation period, the previously seen disparities did not persist (nonwhite Adjusted Coefficient: -0.416, 95% CI: -2.16-1.33; insurance Adjusted Coefficient: 0.812, 95% CI: -1.18-2.80; P > .05).

CONCLUSION

There was no evidence of racial/ethnic or insurance disparities in time from biopsy recommendation to performance after implementation of a same-day biopsy program.