Factors Influencing Patient Confidence in Screening Mammography.

BACKGROUND: We aimed to assess factors associated with patients' confidence in the ability of screening mammography to detect breast cancer. METHODS: Data were analyzed from a cross-sectional, prospective survey conducted in 2017 of women without a breast cancer history who were undergoing screening mammography at our institution. RESULTS: In total, 390 women completed the survey questions relevant to this study. Most respondents were 46 years or older (89.7%), White (87.6%), and college-educated (66.1%). Approximately 80% of respondents reported having confidence in the ability of screening mammography to detect breast cancer. Factors significantly associated with lower confidence in screening mammography were higher education (P = .01) and dense breast tissue (P < .001). Age (P = .12), race (P = .64), family history of breast cancer (P = .17), prior abnormal mammogram (P = .07), and mammogram frequency (P = .42) were nonsignificant. Women with a college education or higher were less likely to report confidence in routine mammography than women with less education (odds ratio [OR]= 0.43; 95% CI, 0.20-0.84; P = .02). Compared with women who reported their breast tissue as not dense, women who were aware they had increased breast density (OR = 0.16; 95% CI, 0.04-0.49; P = .004) or were unaware whether they had increased breast density (OR = 0.17; 95% CI, 0.04-0.51; P = .005) reported less confidence in screening mammography. DISCUSSION: Most respondents were confident in the ability of screening mammography to detect breast cancer. Confidence was inversely associated with education level and self-reported increased breast density. CONCLUSIONS: These findings highlight the importance of continued patient education about the effectiveness of screening mammography for patients with dense breast tissue.

Brugada syndrome unmasked by fever.

Brugada syndrome (BS) is a cardiac rhythm disturbance that predisposes patients to sudden cardiac death. Brugada is classically described with specific electrocardiographic (EKG) findings of ST elevation and right bundle branch block in precordial leads and is an often unrecognized contributor to sudden cardiac death. We present a case of BS with cyclic EKG findings in a febrile 20-year-old active duty, Vietnamese male who presented following a witnessed syncopal event. His classic findings of Brugada pattern on EKG demonstrated reversibility with clinical defervescence. In patients with a suggestive history, a normal EKG cannot definitively rule out BS as the Brugada pattern can be unmasked by stress, which in this case was represented by a pneumonia-induced fever.