You are now better able to get a diagnosis of breast cancer over the phone. Are you OK?

Is the diagnosis of cancer by SMS the next? New research shows that women with breast cancer are increasingly likely to be diagnosed by phone rather than a face-to-face conversation with their doctor.

Perhaps this trend was inevitable, with the widespread use of smartphones and the ability to reach people immediately. For many women with breast cancer, however, being available is not the same as being prepared to learn catastrophic health information over the phone.

Diagnosis while driving

Becky Fields was driving when she learned that her life had changed. Three years ago, Fields was leaving her position as vice president of a private bank in Tulsa, Oklahoma. "I live near the office, so I went home quickly while the nurse explained my diagnosis – while I was driving," she says. "I pulled into my driveway and took a receipt in the back seat of my car."

Lumectomy, radiotherapy, chemotherapy. With shaking hands, Fields noted these words on the receipt she still keeps. "The nurse had explained that I had breast cancer at an early stage and that, fortunately, I had detected it early during my first mammogram," she says. "I wrote the treatment plan that they recommended."

During the call, Fields also noted the name of Susan G. Komen's organization of breast cancer, which the nurse had recommended as a resource if she needed it.

"I did not know what I needed at the time," says Fields. "I was shocked, I hung up and called my boyfriend and my mother.I had so many fears and questions, but we could not answer them before we saw finally my doctor on our next visit. "

In the end, the treatment plan has changed. It turned out that Fields was not a candidate for a lumpectomy and she underwent a double mastectomy. Fortunately, because cancer was detected early and did not spread to the lymph nodes, she was able to avoid radiation and chemotherapy.

For Fields, receiving the totally unexpected diagnosis over the phone was not correct. "The nurse who posed my diagnosis was nice," she says. "But if I could have chosen, I would have certainly preferred the doctor to explain it in the presence of my family, so I did not have to deal with this day alone."

Fields is concerned that telephone diagnosis is becoming commonplace, and she recently learned that she had melanoma.

Although Fields realizes that the medical staff is extremely busy, she adds, "Such a diagnosis is so disturbing. It would be greatly beneficial for the patient's peace of mind to begin this process by holding it lightly in the hand. "

[See: 10 Innovations in Cancer Therapy.]

Less face-to-face diagnosis

Nearly 60% of women are informed by phone of their breast cancer diagnoses, compared to a quarter in 2007, according to the study published online Aug. 17, 2018 in the journal Supportive Care in Cancer.

The results come from responses to an e-mail survey of nearly 2,900 women diagnosed with breast cancer between 1967 and 2017. Over the last decade, the rate of women diagnosed with breast cancer was Breast by phone has increased dramatically, according to the study conducted by Jane McElroy, associate professor of family and community medicine at the University of Missouri's Faculty of Medicine.

Women who learned the news through this phone were more likely to see their family and friends identified as supportive members and a little more likely to have localized breast cancer, rather than an invasive cancer or in propagation. Some women participating in the study had requested a telephone diagnosis.

An earlier study revealed a gap between women's preferences and the reality of how they were diagnosed with breast cancer. Of approximately 785 breast cancer survivors, only 39% were diagnosed face-to-face, although half of the participants chose it, according to the findings of the October 2016 issue of the Annals of Surgical Journal Oncology.

For many women participating in this study, it was important to avoid suspense, with over 80% of them preferring to receive cancer biopsy results within two days. However, only 40% of participants discovered their results quickly.

In both studies, researchers pointed out that white women made up the vast majority of respondents, which means that the results may not necessarily reflect the general population.

[See: What Not to Say to a Breast Cancer Patient.]

Private News in Public

Cati Diamond Stone was in a restaurant having lunch with her husband when she took the call who had taught her that she had breast cancer. Although she is not a screamer, Stone said, "It was certainly a cry call. But I was just stunned and I went back to the table and I tried to understand. Of course, I could not finish my lunch and I left pretty soon after. "

It was April 2010. Stone, who was executive director of Susan G. Komen Greater Atlanta, was a lawyer at the time. The bad news was not quite without notice.

"My diagnosis happened very quickly," says Stone. "The day before, I had a mammogram. I was 35, so they did not think there was anything to worry about. However, she says, "When the assistant radiologist did the screening, she gasped. The same day, I went from a screening mammogram to a diagnostic mammogram, from an ultrasound to three needle biopsies. "

Stone's restaurant experience took place the next day as she and her husband stopped to eat en route to the hospital for her scheduled MRI. "I thought it was an interesting way to spread the news," she said. "I found it confusing not to have told me in person when I arrived at the hospital, instead of telling me on the phone an hour before."

Learning the news this way made it more difficult to manage. "It's still a terrifying phone call," says Stone. "But do it in a place where you have no privacy – how do you react when you're in public and you get such a diagnosis?"

Although Stone had "a million questions," she was inundated with technical information, which she did not understand at the time. "There was compassion in the voice of the nurse who called, of course," she says. "But she took it for granted that I had an idea of ​​what she was talking about, which I certainly did not do."

If instead she had learned her diagnosis in person, Stone thinks she would have been more able to look for answers. Today, thanks to her work at Komen, she meets many women with similar experiences.

"I have so much confidence in these clinicians and their empathy at the thought of making such a diagnosis," Stone said. "But I would just say to make contact as personal as possible and to establish that connection with these women so that they feel able to ask questions – and not stop asking questions until They understand. "

[See: 10 Lessons From Empowered Patients.]

Wear bad news

It is always difficult for doctors to give their patients a diagnosis such as breast cancer. "As surgeons, we often give bad news to our patients," says Dr. Emily Albright, a specialist in surgical oncology at the University of Missouri Health Care and co-author of the latest study. The finding that women are more likely to hear their diagnosis over the phone was not particularly surprising, she says.

"In practical terms, it is often more convenient for patients to get the news over the phone; more to speed up their care, "says Albright. "The other question is: who gives the news? Especially our youngest patients – they may not have a primary care physician with whom they have a relationship. "

If patients need to receive a phone call, health care providers should do their best to prepare them. "Ask the person if the time is right," advises Albright.

A sudden flow of information, that is too much. "It's helpful to have breaks in the conversation to allow a person to digest what you've told them," says Albright. "Sometimes, when you give the news over the phone, if you can then have a conversation in person soon after, it often gives the patient time to formulate questions or perhaps have a more productive discussion about the next steps. "

It's also important to be sensitive to the patient's environment, notes Albright: "Driving may not be the perfect time for a phone conversation." Whether over the phone or In person, she says, "Doctor, it's never easy to give bad news. We want our patients to succeed. And announcing bad news to patients hurts us too.

For patients who know how they prefer to be diagnosed, "Thank you for telling us," says Albright. "But I also think it's up to us to ask if we can call you with results or if you want an appointment to discuss it."

More American news

10 seemingly innocent symptoms not to ignore

10 lessons of empowered patients

13 things your nurse knew about you

You are now better able to get a diagnosis of breast cancer over the phone. Are you OK? originally appeared on usnews.com