“Screening isn’t Your Ticket to Vacation”: In-depth Interviews With Women in the United States Who Experienced an Interval Breast Cancer

Abstract

Introduction: Interval breast cancers are detected symptomatically after a non-suspicious mammogram, but before the patient’s next scheduled screen. Interval breast cancers are often diagnosed at a later stage and larger size, and have poorer prognostic factors and survival than screen-detected breast cancer. Our qualitative study heard from women with interval breast cancer to describe their symptoms and their reactions to the diagnosis; and identify themes for educational messaging. Methods: We conducted 20 in-depth interviews with participants who were between the ages 40-69, had all screening, diagnostic, and treatment services completed within the same hospital system, and had a negative mammogram screen followed by breast cancer diagnosis before the next screen. Results: Fifteen women noticed a lump cyst during a breast self-exam or when dressing. Most women reached out to their gynecologist or their primary care provider. Main themes from their reactions to the diagnosis included: unaware that interval breast cancers could occur; surprised that screening tools could not see all cancer; worried to being seen as ridiculous based on previous experience with non-cancerous breast issues, and disappointed that they waited to reach out for care. Ideas for messaging included: listen to your body, prioritize your health, and keep doing breast self-exams. Conclusion: Breast cancer prevention programs should focus on the awareness of interval breast cancers and the importance of breast self-exams and self-awareness in conjunction with screening mammograms.