Photo of Mara A. Schonberg,  MD, MPH

Mara A. Schonberg, MD, MPH

Beth Israel Deaconess Medical Center

Beth Israel Deaconess Medical Center


mschonbe@bidmc.harvard.edu

Mara A. Schonberg, MD, MPH

Beth Israel Deaconess Medical Center

EDUCATIONAL TITLES

  • Associate Professor, Medicine, Harvard Medical School
  • Associate Professor, General Medicine and Primary Care, Beth Israel Deaconess Medical Center

DF/HCC PROGRAM AFFILIATION

Research Abstract

Dr. Schonberg is an Associate Professor of Medicine at Harvard Medical School, a practicing internist, and Director of Research in Shared Decision Making in the Division of General Medicine at Beth Israel Deaconess Medical Center (BIDMC). Her research aims to improve shared decision making around cancer screening for older adults and has been supported by 3 NIH R01 grants, 2 R21s, a Paul B. Beeson K23, and multiple foundation grants. Since high quality breast cancer screening decisions for older women require consideration of their life expectancy, breast cancer risk, and preferences and values, most of her work has aimed to better understand each of these key factors. To help clinicians and patients estimate life expectancy, she developed and validated a widely used index to predict mortality within 14 years that is available at www.eprognosis.org, a website that she co-developed. To help older women make more informed preference-based screening decisions around mammography screening, she developed a pamphlet decision aid (DA) on mammography screening for women 75+ years and recently completed a large multi-site cluster randomized controlled trial testing the DA’s efficacy. The DA improved older women’s knowledge about screening, led to more discussion with PCPs, and led to fewer older women being screened. Dr. Schonberg is also developing scripts and strategies for clinicians to use to discuss stopping screening with older adults. In addition, she is working to improve shared decision making around treatment of breast cancer in older women and on improving shared decision making around breast cancer screening for women in their 40s. In recognition of her work, Dr. Schonberg received the 2016 American Geriatrics Society (AGS) Outstanding Scientific Achievement for Clinical Investigation Award and a 2015 Clinician Investigator of the Year Award from the New England Region of the Society of General Internal Medicine.

Publications from Harvard Catalyst Profiles

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  • Patell R, Bindal P, Dodge L, Elavalakanar P, Freed JA, Rangachari D, Buss M, Schonberg M, Braun I. Oncology Fellows' Clinical Discussions, Perceived Knowledge, and Formal Training Regarding Medical Cannabis Use: A National Survey Study. JCO Oncol Pract 2022. PubMed
  • Minami CA, Jin G, Schonberg MA, Freedman RA, King TA, Mittendorf EA. Variation in Deescalated Axillary Surgical Practices in Older Women with Early-Stage Breast Cancer. Ann Surg Oncol 2022. PubMed
  • Schonberg MA, Karamourtopoulos M, Pinheiro A, Davis RB, Sternberg SB, Mehta TS, Gilliam EA, Tung NM. Variation in Breast Cancer Risk Model Estimates Among Women in Their 40s Seen in Primary Care. J Womens Health (Larchmt) 2022; 31:495-502. PubMed
  • Jindal SK, Karamourtopoulos M, Jacobson AR, Pinheiro A, Smith AK, Hamel MB, Schonberg MA. Strategies for discussing long-term prognosis when deciding on cancer screening for adults over age 75. J Am Geriatr Soc 2022. PubMed
  • Park C, Park SK, Upshaw JN, Schonberg MA. In-hospital mortality, length of stay and hospital costs for hospitalized breast cancer patients with comorbid heart failure in the USA. Curr Med Res Opin 2021. PubMed
  • Cadet T, Pinheiro A, Karamourtopoulos M, Jacobson AR, Aliberti GM, Kistler CE, Davis RB, Schonberg MA. Effects by educational attainment of a mammography screening patient decision aid for women aged 75 years and older. Cancer 2021. PubMed
  • Cadet T, Aliberti G, Karamourtopoulos M, Jacobson A, Siska M, Schonberg MA. Modifying a Mammography Decision Aid for Older Adult Women with Risk Factors for Low Health Literacy. Health Lit Res Pract 2021; 5:e78-e90. PubMed
  • Minami CA, Freedman RA, Karamourtopoulos M, Pinheiro A, Gilliam E, Aliberti G, Pories SE, Recht A, Lotz M, Dominici LS, Schonberg MA. Acceptability of a patient decision aid for women aged 70 and older with stage I, estrogen receptor-positive, HER2-negative breast cancer. 2021. PubMed
  • Cadet T, Aliberti G, Karamourtopoulos M, Jacobson A, Gilliam EA, Primeau S, Davis R, Schonberg MA. Evaluation of a mammography decision aid for women 75 and older at risk for lower health literacy in a pretest-posttest trial. Patient Educ Couns 2021. PubMed
  • Freedman RA, Minami CA, Winer EP, Morrow M, Smith AK, Walter LC, Sedrak MS, Gagnon H, Perilla-Glen A, Wildiers H, Wildes TM, Lichtman SM, Loh KP, Brain EGC, Ganschow PS, Hunt KK, Mayer DK, Ruddy KJ, Jagsi R, Lin NU, Canin B, LeStage BK, Revette AC, Schonberg MA, Keating NL. Individualizing Surveillance Mammography for Older Patients After Treatment for Early-Stage Breast Cancer: Multidisciplinary Expert Panel and International Society of Geriatric Oncology Consensus Statement. JAMA Oncol 2021. PubMed
  • Maschke A, Paasche-Orlow MK, Kressin NR, Schonberg MA, Battaglia TA, Gunn CM. Discussions of Potential Mammography Benefits and Harms among Patients with Limited Health Literacy and Providers: "Oh, There are Harms?" J Health Commun 2021. PubMed
  • Schoenborn NL, Pinheiro A, Kistler CE, Schonberg MA. Association between Breast Cancer Screening Intention and Behavior in the Context of Screening Cessation in Older Women. Med Decis Making 2021; 41:240-244. PubMed
  • Gunn CM, Maschke A, Paasche-Orlow MK, Kressin NR, Schonberg MA, Battaglia TA. Engaging Women with Limited Health Literacy in Mammography Decision-Making: Perspectives of Patients and Primary Care Providers. J Gen Intern Med 2020. PubMed
  • Pajka SE, Hasdianda MA, George N, Sudore R, Schonberg MA, Bernstein E, Tulsky JA, Block SD, Ouchi K. Feasibility of a Brief Intervention to Facilitate Advance Care Planning Conversations for Patients with Life-Limiting Illness in the Emergency Department. J Palliat Med 2020. PubMed
  • Schonberg MA, Kistler CE, Pinheiro A, Jacobson AR, Aliberti GM, Karamourtopoulos M, Hayes M, Neville BA, Lewis CL, Wee CC, Fagerlin A, Nekhlyudov L, Marcantonio ER, Hamel MB, Davis RB. Effect of a Mammography Screening Decision Aid for Women 75 Years and Older: A Cluster Randomized Clinical Trial. JAMA Intern Med 2020. PubMed
  • Schonberg MA, Jacobson AR, Karamourtopoulos M, Aliberti GM, Pinheiro A, Smith AK, Schuttner LC, Park ER, Hamel MB. Scripts and Strategies for Discussing Stopping Cancer Screening with Adults > 75 Years: a Qualitative Study. J Gen Intern Med 2020. PubMed
  • Schonberg MA, Karamourtopoulos M, Jacobson AR, Aliberti GM, Pinheiro A, Smith AK, Davis RB, Schuttner LC, Hamel MB. A Strategy to Prepare Primary Care Clinicians for Discussing Stopping Cancer Screening With Adults Older Than 75 Years. 2020; 4:igaa027. PubMed
  • Schonberg MA, Davis RB, Karamourtopoulos MC, Pinheiro A, Sternberg SB, Jacobson AR, Aliberti GM, Mehta TS, Cluett JL, Cohen ML, Atlas T, Tung NM. A Pre-Test-Post-Test Trial of a Breast Cancer Risk Report for Women in Their 40s. Am J Prev Med 2020; 59:343-354. PubMed
  • Schonberg MA, Jacobson AR, Aliberti GM, Hayes M, Hackman A, Karamourtopolous M, Kistler C. Primary Care-Based Staff Ideas for Implementing a Mammography Decision Aid for Women 75+: a Qualitative Study. J Gen Intern Med 2019. PubMed
  • Schonberg MA, Freedman RA, Recht AR, Jacobson AR, Aliberti GM, Karamourtopoulos M, Nakhlis F, McCarthy EP, Pories SE, Sharma R, Dominici LS. Developing a patient decision aid for women aged 70 and older with early stage, estrogen receptor positive, HER2 negative, breast cancer. 2019. PubMed
  • Ouchi K, George N, Schuur JD, Aaronson EL, Lindvall C, Bernstein E, Sudore RL, Schonberg MA, Block SD, Tulsky JA. Goals-of-Care Conversations for Older Adults With Serious Illness in the Emergency Department: Challenges and Opportunities. Ann Emerg Med 2019. PubMed
  • Fowler NR, Schonberg MA, Sachs GA, Schwartz PH, Gao S, Lane KA, Inger L, Torke AM. Supporting breast cancer screening decisions for caregivers of older women with dementia: study protocol for a randomized controlled trial. Trials 2018; 19:678. PubMed
  • Ouchi K, George N, Revette AC, Hasdianda MA, Fellion L, Reust A, Powell LH, Sudore R, Schuur JD, Schonberg MA, Bernstein E, Tulsky JA, Block SD. Empower Seriously Ill Older Adults to Formulate Their Goals for Medical Care in the Emergency Department. J Palliat Med 2018. PubMed
  • Mohile SG, Dale W, Somerfield MR, Schonberg MA, Boyd CM, Burhenn PS, Canin B, Cohen HJ, Holmes HM, Hopkins JO, Janelsins MC, Khorana AA, Klepin HD, Lichtman SM, Mustian KM, Tew WP, Hurria A. Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy: ASCO Guideline for Geriatric Oncology. J Clin Oncol 2018. PubMed
  • Schonberg MA. Overutilization of Breast Cancer Screening in the US: Awareness of a Growing Problem. J Gen Intern Med 2017. PubMed
  • Freedman RA, Keating NL, Pace LE, Lii J, McCarthy EP, Schonberg MA. Use of Surveillance Mammography Among Older Breast Cancer Survivors by Life Expectancy. J Clin Oncol 2017; 35:3123-3130. PubMed
  • Bareket R, Schonberg MA, Comaneshter D, Schonmann Y, Shani M, Cohen A, Vinker S. Cancer Screening of Older Adults in Israel According to Life Expectancy: Cross Sectional Study. J Am Geriatr Soc 2017. PubMed
  • Schonberg MA. Decision-Making Regarding Mammography Screening for Older Women. J Am Geriatr Soc 2016; 64:2413-2418. PubMed
  • Schonberg MA, Li VW, Eliassen AH, Davis RB, LaCroix AZ, McCarthy EP, Rosner BA, Chlebowski RT, Hankinson SE, Marcantonio ER, Ngo LH. Accounting for individualized competing mortality risks in estimating postmenopausal breast cancer risk. Breast Cancer Res Treat 2016; 160:547-562. PubMed
  • Ouchi K, Block SD, Schonberg MA, Jamieson ES, Aaronson EL, Pallin DJ, Tulsky JA, Schuur JD. Feasibility Testing of an Emergency Department Screening Tool to Identify Older Adults Appropriate for Palliative Care Consultation. J Palliat Med 2016. PubMed
  • Burns RB, Schonberg MA, Tung NM, Libman H. Should We Offer Medication to Reduce Breast Cancer Risk?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center. Ann Intern Med 2016; 165:194-204. PubMed
  • Bychkovsky BL, Schonberg MA. Poor persistence with hormonal therapy among women with breast cancer. 2016; 7:154-7. PubMed
  • Breslau ES, Gorin SS, Edwards HM, Schonberg MA, Saiontz N, Walter LC. An Individualized Approach to Cancer Screening Decisions in Older Adults: A Multilevel Framework. J Gen Intern Med 2016; 31:539-47. PubMed
  • Schonberg MA, Li VW, Eliassen AH, Davis RB, LaCroix AZ, McCarthy EP, Rosner BA, Chlebowski RT, Rohan TE, Hankinson SE, Marcantonio ER, Ngo LH. Performance of the Breast Cancer Risk Assessment Tool Among Women Age 75 Years and Older. Journal of the National Cancer Institute 2016. PubMed
  • Schonberg MA, Breslau ES, Hamel MB, Bellizzi KM, McCarthy EP. Colon cancer screening in U.S. adults aged 65 and older according to life expectancy and age. J Am Geriatr Soc 2015; 63:750-6. PubMed
  • Schonberg MA, Breslau ES. Mammography screening for women aged 70 and older: at a crossroads. J Am Geriatr Soc 2015; 63:170-2. PubMed
  • Schonberg MA, Silliman RA, Ngo LH, Birdwell RL, Fein-Zachary V, Donato J, Marcantonio ER. Older women's experience with a benign breast biopsy—a mixed methods study. J Gen Intern Med 2014. PubMed
  • Drazer MW, Prasad SM, Huo D, Schonberg MA, Dale W, Szmulewitz RZ, Eggener SE. National trends in prostate cancer screening among older American men with limited 9-year life expectancies: evidence of an increased need for shared decision making. Cancer 2014. PubMed
  • Schonberg MA, Birdwell RL, Bychkovsky BL, Hintz L, Fein-Zachary V, Wertheimer MD, Silliman RA. Older women's experience with breast cancer treatment decisions. Breast Cancer Res Treat 2014; 145:211-23. PubMed
  • Schonberg MA, Hamel MB, Davis RB, Griggs MC, Wee CC, Fagerlin A, Marcantonio ER. Development and evaluation of a decision aid on mammography screening for women 75 years and older. JAMA Intern Med 2014; 174:417-24. PubMed
  • Schonberg MA, Breslau ES, McCarthy EP. Targeting of mammography screening according to life expectancy in women aged 75 and older. J Am Geriatr Soc 2013; 61:388-95. PubMed
  • Drazer MW, Huo D, Schonberg MA, Razmaria A, Eggener SE. Population-based patterns and predictors of prostate-specific antigen screening among older men in the United States. J Clin Oncol 2011. PubMed
  • Schonberg MA, Marcantonio ER, Ngo L, Li D, Silliman RA, McCarthy EP. Causes of death and relative survival of older women after a breast cancer diagnosis. J Clin Oncol 2011. PubMed
  • Smith AK, Schonberg MA, Fisher J, Pallin DJ, Block SD, Forrow L, McCarthy EP. Emergency department experiences of acutely symptomatic patients with terminal illness and their family caregivers. J Pain Symptom Manage 2010; 39:972-81. PubMed
  • Schonberg MA, Marcantonio ER, Li D, Silliman RA, Ngo L, McCarthy EP. Breast cancer among the oldest old: tumor characteristics, treatment choices, and survival. J Clin Oncol 2010; 28:2038-45. PubMed
  • Schonberg MA, Davis RB, McCarthy EP, Marcantonio ER. Index to predict 5-year mortality of community-dwelling adults aged 65 and older using data from the national health interview survey. J Gen Intern Med 2009; 24:1115-22. PubMed
  • Smith AK,Fisher J,Schonberg MA,Pallin DJ,Block SD,Forrow L,Phillips RS,McCarthy EP. Am I Doing the Right Thing? Provider Perspectives on Improving Palliative Care in the Emergency Department. Ann Emerg Med 2009; 54:86-93, 93.e1. PubMed
  • Schonberg MA,Silliman RA,Marcantonio ER. Weighing the benefits and burdens of mammography screening among women age 80 years or older. J Clin Oncol 2009; 27:1774-80. PubMed
  • Schonberg MA,McCarthy EP. Mammography screening among women age 80 years and older: consider the risks. J Clin Oncol 2009; 27:640-1; author reply 641-2. PubMed
  • Schonberg MA,Leveille SG,Marcantonio ER. Preventive health care among older women: missed opportunities and poor targeting. Am J Med 2008; 121:974-81. PubMed
  • Schonberg MA,York M,Basu N,Olveczky D,Marcantonio ER. Preventive health care among older women in an academic primary care practice. Womens Health Issues 2008; 18:249-56. PubMed
  • Schonberg MA, McCarthy EP, York M, Davis RB, Marcantonio ER. Factors influencing elderly women's mammography screening decisions: implications for counseling. BMC Geriatr 2007; 7:26. PubMed
  • Schonberg MA, Ramanan RA, McCarthy EP, Marcantonio ER. Decision making and counseling around mammography screening for women aged 80 or older. J Gen Intern Med 2006; 21:979-85. PubMed
  • Schonberg MA, Marcantonio ER, Wee CC. Receipt of exercise counseling by older women. J Am Geriatr Soc 2006; 54:619-26. PubMed
  • Kotwal AA, Schonberg MA. Cancer Screening in the Elderly: A Review of Breast, Colorectal, Lung, and Prostate Cancer Screening. Cancer J ; 23:246-253. PubMed
  • Gunn CM, Maschke A, Paasche-Orlow MK, Housten AJ, Kressin NR, Schonberg MA, Battaglia TA. Using Mixed Methods With Multiple Stakeholders to Inform Development of a Breast Cancer Screening Decision Aid for Women With Limited Health Literacy. MDM Policy Pract ; 6:23814683211033249. PubMed
  • Schonberg MA, Hamel MB, Davis RB, Karamourtopoulos M, Pinheiro A, Hayes MC, Wee CC, Kistler C. Primary Care Providers' Perceptions of the Acceptability, Appropriateness, and Feasibility of a Mammography Decision Aid for Women Aged 75 and Older. MDM Policy Pract ; 7:23814683221074310. PubMed
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