Breast density is one factor in assessing a person’s risk of developing breast cancer. Existing breast density notification laws have increased awareness among patients and providers, but clinical records had not been incorporated in studies to confirm the accuracy of personal breast density knowledge. A research team at Dartmouth Cancer Center worked with the Breast Cancer Surveillance Consortium to both survey women and incorporate their clinical records from 15 mammography facilities across three states to find out how much women knew about their own breast density. Their findings were published by Smith et al in the Journal of the American College of Radiology.
The researchers found that while breast density knowledge may be increasing due to existing state laws, there is still room for improvement. They suggested that clinicians need tools to engage with women in understanding their personal breast cancer risks and screening options.
“Particular consideration should be given to those with lower literacy in the design of those tools,” says lead author Rebecca E. Smith, MS, of the Dartmouth Institute for Health Policy and Clinical Practice. “There may also be benefit to standardized breast density communications for all women—women with dense and nondense breasts—as opposed to just women with dense breasts.”
Study Details and Findings
The team set out to measure accuracy and predictors of women’s breast density knowledge in a nationally representative sample of women eligible for breast cancer screening who had not had a previous breast cancer. They also examined women’s understanding of the implications of breast density and breast density’s impact on future screening intentions.
The majority (76%) of women with dense breasts correctly knew their breast density, whereas most women with nondense breasts did not (14%). About one-third of women with nondense breasts believed they had dense breasts, and women who believed they had dense breasts were more likely than women who believed they had nondense breasts to want supplemental screening.
Density reporting to all women, compared to only women with dense breasts, was associated with an increased chance of accurate breast density knowledge for women with nondense breasts. Lower education was associated with a lower chance of correctly knowing one’s own density.
“Health-care providers will need decision support tools to keep informed of evolving evidence on who may benefit from supplemental screening and for engaging women in shared decision-making,” said Ms. Smith. “Density notifications should be tailored and accessible to a wide range of literacy levels. There may be benefit to standardized breast density communications for both women with dense and [those with] nondense breasts.”
Anna N.A. Tosteson, ScD, the study’s senior author, added, “Our study’s findings are important for policymakers to consider when designing pending national breast density notification regulations.”
Disclosure: For full disclosures of the study authors, visit jacr.org.
