Mammographic Breast Density as a Risk Factor for Breast Cancer: Awareness in a Recently Screened Clinical Sample

O’Neill, Suzanne C.; Leventhal, Kara Grace; Scarles, Marie; Evans, Chalanda N.; Makariou, Erini; Pien, Edward; Willey, Shawna C.

doi:10.1016/j.whi.2014.02.005

Cited by 28 publications

(36 citation statements)

References 35 publications

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“…Most women do not know their BC risk estimates despite the online availability of many risk models, including the Gail model, and their use in some clinical settings (Fehniger et al, 2014). Mammographic density, one of the strongest risk factors for breast cancer (McCormack & dos Santos Silva, 2006), has only recently entered the public lexicon as a growing number of states, including New York State, have issued legal mandates for the release of this information to women determined by radiologists as having dense breasts (O’Neill et al, 2014; Rhodes, Radecki Breitkopf, Ziegenfuss, Jenkins, & Vachon, 2015). Nonetheless, we considered these indicators of objective risk as both the Gail model estimates and mammographic density map to many established risk factors for breast cancer (e.g., family history, age at first live birth), and thus, women with knowledge of these breast cancer risk factors may have some awareness of their personal risk.…”

Section: Resultsmentioning

confidence: 99%

Predictors of Breast Cancer Worry in a Hispanic and Predominantly Immigrant Mammography Screening Population

April-Sanders

Oskar

Shelton

et al. 2017

Women's Health Issues

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Objective Worry about developing breast cancer (BC worry) has been associated with participation in screening and genetic testing and with follow-up of abnormal screening results. Little is known about the scope and predictors of BC worry in Hispanic and immigrant populations. Methods We collected in-person interview data from 250 self-identified Hispanic women recruited from an urban mammography facility (average age 50.4 years; 82% foreign-born). Women reported whether they worried about developing breast cancer rarely/never (low worry), sometimes (moderate worry) or often/all the time (high worry). We examined whether sociocultural and psychological factors (e.g., acculturation, education, perceived risk), and risk factors and objective risk for breast cancer (e.g., family history, Gail model 5-year risk estimates, parity) predicted BC worry using multinomial and binary logistic regression. Results In multivariable models, women who perceived higher absolute breast cancer risk (OR=1.66, 95% CI: 1.28, 2.14 for one unit increase in perceived lifetime risk) and comparative breast cancer risk (e.g., OR=2.37, 95% CI: 1.23, 6.06) were more likely to report high BC worry than moderate or low BC worry. There were no associations between BC worry and indicators of objective risk or acculturation. Conclusions In Hispanic women undergoing screening mammography, higher perceptions of breast cancer risk, on both absolute and comparative terms, were independently associated with high BC worry, and were stronger predictors of BC worry than indicators of objective breast cancer risk, including family history, mammographic density and personal breast cancer risk estimates.

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Section: Resultsmentioning

confidence: 99%

Predictors of Breast Cancer Worry in a Hispanic and Predominantly Immigrant Mammography Screening Population

April-Sanders

Oskar

Shelton

et al. 2017

Women's Health Issues

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“…Participants received a $20 gift card to thank them for their time. All participants provided written, informed consent …”

Section: Methodsmentioning

confidence: 99%

Breast density in multiethnic women presenting for screening mammography

et al. 2017

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Data on ethnic variations in breast density are limited and often not inclusive of underrepresented minorities. As breast density is associated with elevated breast cancer risk, investigating racial and ethnic difference may elucidate the observed differences in breast cancer risk among different populations. We reviewed breast density from initial screening of women from the Capital Breast Care Center and Georgetown University Hospital from 2010 to 2014. Patient demographics including race, age at screening, education, menopausal status, and body mass index were abstracted. We recorded the BI-RADS density categories: (1) "fatty," (2) "scattered fibroglandular densities," (3) "heterogeneously dense," and (4) "extremely dense." Multivariable unconditional logistic regression was used to identify predictors of breast density. Density categorization was recorded for 2146 women over the 5-year period, comprising Blacks (n = 940), Hispanics (n = 893), and Whites (n = 314). Analysis of subject characteristics by breast density showed that high category is observed in younger, Hispanic, nulliparous, premenopausal, and nonobese women (t-test or chi-square test, P-values <.0001). Obese women are 70% less likely to have high density. Being Hispanic, premenopausal, and nonobese were predictive of high density on logistic regression. In this analysis of density distribution in a diverse sample, Hispanic women have the highest breast density, followed by Blacks and Whites. Unique in our findings is women who identify as Hispanic have the highest breast density and lower rates of obesity. Further investigation of the impact of obesity on breast density, especially in the understudied Hispanic group is needed.

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“…Having dense breasts (i.e., more fibro-glandular relative to fatty breast tissue) increases women’s breast cancer (BC) risk up to 4.5-fold (Barlow et al, 2006; Boyd et al, 2011; McCormack & dos Santos Silva, 2006); however, many women are often unaware of their own breast density (BD) and the associated increased BC risk (Manning et al, 2013; O’Neill et al, 2014; Rhodes et al, 2015; Trinh et al, 2015). Consequently, BD notification laws, which mandate that mammogram reports disclose when a patient has dense breasts, have been adopted in 27 states in the United States thus far (Are You Dense Advocacy Inc, 2016).…”

Section: Introductionmentioning

confidence: 99%

Explaining between-race differences in African-American and European-American women's responses to breast density notification

Manning

Albrecht

Yilmaz-Saab

et al. 2017

Social Science & Medicine

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Background: Prior research shows between-race differences in women’s knowledge and emotions related to having dense breasts, thus suggesting that between-race differences in behavioral decision-making following receipt of breast density (BD) notifications are likely. Guided by the theory of planned behavior, this study examined differences in emotion-related responses (i.e., anxiety, worry, confusion) and behavioral cognition (e.g., intentions, behavioral attitudes) following receipt of BD notifications among African American (AA) and European American (EA) women. This study also examined whether race-related perceptions (i.e., discrimination, group-based medical mistrust), relevant knowledge and socioeconomic status (SES) explained the between race differences. Method: Michigan women (N = 457) who presented for routine screening mammogram and had dense breasts, no prior breast cancer diagnoses, and had screen-negative mammograms were recruited from July, 2015 to March 2016. MANOVA was used to examine between race differences in psychological responses (i.e., emotional responses and behavioral cognition), and a multi-group structural regression model was used to examine whether race-related constructs, knowledge and SES mediated the effect of race on emotional responses and behavioral cognition. Prior awareness of BD was accounted for in all analyses. Results: AA women generally reported more negative psychological responses to receiving BD notifications regardless of prior BD awareness. AA women had more favorable perceptions related to talking to their physicians about the BD notifications. Generally, race-related perceptions, SES, and related knowledge partially accounted for the effect of race on psychological response. Race-related perceptions and SES partially accounted for the differences in behavioral intentions. Between-race differences in emotional responses to BD notifications did not explain differences in women’s intentions to discuss BD notifications with their physicians. Conclusions: Future examinations are warranted to examine whether there are between-race differences in actual post-BD notification behaviors and whether similar race-related variables account for differences.

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Mammographic Breast Density as a Risk Factor for Breast Cancer: Awareness in a Recently Screened Clinical Sample

Cited by 28 publications

References 35 publications

Predictors of Breast Cancer Worry in a Hispanic and Predominantly Immigrant Mammography Screening Population

Predictors of Breast Cancer Worry in a Hispanic and Predominantly Immigrant Mammography Screening Population

Breast density in multiethnic women presenting for screening mammography

Explaining between-race differences in African-American and European-American women's responses to breast density notification

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