Starting breast cancer screening at age 40 versus 50 may increase potential harms frequency with a small mortality benefit. Younger women’s screening decisions, therefore, may be complex. Shared decision-making (SDM) is recommended for women under 50 and may support women under 55 for whom guidelines vary. How women with limited health literacy (LHL) approach breast cancer screening decision-making is less understood, and most SDM tools are not designed with their input. This phenomenological study sought to characterize mammography counseling experiences among women with LHL and primary care providers (PCPs). Women ages 40–54 with LHL who had no history of breast cancer or mammogram within 9 months were approached before a primary care visit at a safety-net hospital. PCPs at this site were invited to participate. Qualitative interviews explored mammography counseling experiences. Patients also reviewed sample information materials. A constant comparison technique generated four themes salient to 25 patients and 20 PCPs: addressing family history versus comprehensive risk assessment; potential mammography harms discussions; information delivery preferences; and integrating pre-visit information tools. Findings suggest that current counseling techniques may not be responsive to patient-identified needs. Opportunities exist to improve how mammography information is shared and increase accessibility across the health literacy spectrum.

在 40 岁和 50 岁开始进行乳腺癌筛查可能会增加潜在的危害频率，但对死亡率的益处很小。因此，年轻女性的筛查决定可能很复杂。建议 50 岁以下的女性使用共享决策 (SDM)，并可能支持 55 岁以下的女性，但指南各不相同。对健康素养有限 (LHL) 的女性如何进行乳腺癌筛查决策的了解较少，而且大多数 SDM 工具的设计都没有考虑到她们的意见。这项现象学研究旨在描述 LHL 女性和初级保健提供者 (PCP) 的乳房 X 光检查咨询经历。年龄在 40-54 岁的 LHL 女性在 9 个月内没有乳腺癌或乳房 X 光检查史，然后在安全网医院进行初级保健就诊。本网站的 PCP 受邀参加。定性访谈探讨了乳房 X 光检查咨询经验。患者还查看了样本信息材料。持续比较技术产生了 25 名患者和 20 名 PCP 的四个突出主题：解决家族史与综合风险评估；潜在的乳房 X 光检查会损害讨论；信息传递偏好；并集成访问前信息工具。研究结果表明，当前的咨询技术可能无法满足患者确定的需求。存在改善乳房 X 光检查信息共享方式和提高整个健康素养范围的可及性的机会。处理家族史与综合风险评估；潜在的乳房 X 光检查会损害讨论；信息传递偏好；并集成访问前信息工具。研究结果表明，当前的咨询技术可能无法满足患者确定的需求。存在改善乳房 X 光检查信息共享方式和提高整个健康素养范围的可及性的机会。处理家族史与综合风险评估；潜在的乳房 X 光检查会损害讨论；信息传递偏好；并集成访问前信息工具。研究结果表明，当前的咨询技术可能无法满足患者确定的需求。存在改善乳房 X 光检查信息共享方式和提高整个健康素养范围的可及性的机会。