Patient-Reported Breast Density Awareness and Knowledge after Breast Density Legislation Passage

Miles, Randy C.; Lehman, Constance D.; Warner, Erica T.; Tuttle, Ashley; Saksena, Mansi

doi:10.1016/j.acra.2018.07.004

Cited by 26 publications

(25 citation statements)

References 15 publications

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“…Despite having a history of dense breasts, the majority of women in the current study did not recall receiving written communication of this information, and were unaware of and unfamiliar with the construct of breast density. These findings are congruent with the majority of survey studies reporting low levels of awareness and understanding of breast density, particularly in women of lower socioeconomic status and those from racial/ethnic minority groups . To our knowledge, fewer studies to date have assessed women’s knowledge of their personal breast density or women’s understanding of the BDN information that is communicated to them.…”

Section: Discussionsupporting

confidence: 84%

“…Women in the current study were interested in learning about breast density, and believed that having a knowledge of their personal breast density could help them to make more informed decisions regarding breast cancer screening. This reasoning, which is in line with prior reports and the motivating force behind advocating for BDN legislation, demonstrates that women value and find the knowledge of their breast density to be consequential for their breast health. Although women recommended varied communication methods ranging from pamphlets to social media outlets, they nearly universally stated that health care providers should be the point person to educate women about breast density and many voiced explicit plans to follow up with their providers at their next visit.…”

Section: Discussionsupporting

confidence: 76%

“…In the current study, we explored women’s perspectives regarding BDN through qualitative interviews and open‐ended questions, thereby contributing more in‐depth information concerning emotional, cognitive, and behavioral responses to BDN among predominantly immigrant women, who may face unique linguistic and health care access barriers . In addition, we focused on Hispanic women, who have been found in prior studies to have very low knowledge of breast density . The current study sample, although primarily composed of Caribbean Hispanic women recruited from a large urban community mammography clinic, had substantial diversity with regard to sociodemographic characteristics, including educational background and health literacy, and represented nearly equal numbers of English‐speaking and Spanish‐speaking women.…”

Section: Discussionmentioning

confidence: 99%

“…These findings are congruent with the majority of survey studies reporting low levels of awareness and understanding of breast density, particularly in women of lower socioeconomic status and those from racial/ethnic minority groups. [6][7][8][9] To our knowledge, fewer studies to date have assessed women's knowledge of their personal breast density or women's understanding of the BDN information that is communicated to them. It is important to note that we examined Hispanic women's immediate comprehension of the notification information after reading the mandated text, which captures a more realistic assessment of the extent to which women unfamiliar with breast density understand the information.…”

Section: Discussionmentioning

confidence: 99%

“…Cancer June 15, 2019 Several surveys have documented varying levels of awareness of breast density and its relationship with breast cancer detection and risk, with less knowledge reported among women of lower socioeconomic status and those of racial/ethnic minority groups. [6][7][8][9] A survey of over 2,300 women of screening age reported that greater than one-half of respondents had heard of breast density, but this awareness varied from 23% in Hispanic women to 65% in non-Hispanic white women. 10 How women understand, perceive, and act on personal breast density information, as conveyed through BDN, remain largely unknown.…”

Section: Introductionmentioning

confidence: 99%

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“You probably can’t feel as safe as normal women”: Hispanic women’s reactions to breast density notification

Pacsi‐Sepulveda

Shelton

Rodríguez

et al. 2019

Cancer

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Background Patient advocacy has led to state‐level legislative mandates for the release of personal mammographic breast density information to women undergoing screening mammography. More research is needed to understand the impact of this information on women’s perceptions and mammography screening behavior. Methods Semistructured interviews were conducted in English and Spanish with 24 self‐identified Hispanic women who had undergone at least 1 mammogram since breast density notification was enacted in New York State. The women ranged in age from 43 to 63 years. Women were asked about their understanding and perceptions of the communication of New York State‐mandated breast density information, and any actions they have taken or would take in response to this information. A content analysis of the qualitative data from the translated and transcribed interviews was conducted. Results The majority of participants had no prior knowledge of breast density and expressed confusion and apprehension regarding the meaning of dense breasts when presented with the notification information. Many participants understood having dense breasts to be a serious and abnormal condition, and reported feelings of worry and vulnerability. Participants mostly expressed a strong interest in learning about breast density and obtaining additional and more frequent breast cancer screening tests. These behavioral intentions were consistent with participants’ overall favorable view of breast cancer screening and a belief that their faith, as well as regular screening, can help to protect them from breast cancer morbidity and mortality. Conclusions Hispanic women conveyed proactive breast cancer screening intentions in response to breast density notification, despite inadequate comprehension of this information and negative emotional responses.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

“You probably can’t feel as safe as normal women”: Hispanic women’s reactions to breast density notification

Pacsi‐Sepulveda

Shelton

Rodríguez

et al. 2019

Cancer

View full text Add to dashboard Cite

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Perceptions of Breast Cancer Risks Among Women Receiving Mammograph Screening

et al. 2023

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ImportanceBreast density is an independent risk factor for breast cancer. Despite the proliferation of mandated written notifications about breast density following mammography, there is little understanding of how women perceive the relative breast cancer risk associated with breast density.ObjectiveTo assess women’s perception of breast density compared with other breast cancer risks and explore their understanding of risk reduction.Design, Setting, and ParticipantsThis mixed-methods qualitative study used telephone surveys and semistructured interviews to investigate perceptions about breast cancer risk among a nationally representative, population-based sample of women. Eligible study participants were aged 40 to 76 years, reported having recently undergone mammography, had no history of prior breast cancer, and had heard of breast density. Survey participants who had been informed of their personal breast density were invited for a qualitative interview. Survey administration spanned July 1, 2019, to April 30, 2020, with 2306 women completing the survey. Qualitative interviews were conducted from February 1 to May 30, 2020.Main Outcomes and MeasuresRespondents compared the breast cancer risk associated with breast density with 5 other risk factors. Participants qualitatively described what they thought contributed to breast cancer risk and ways to reduce risk.ResultsOf the 2306 women who completed the survey, 1858 (166 [9%] Asian, 503 [27%] Black, 268 [14%] Hispanic, 792 [43%] White, and 128 [7%] other race or ethnicity; 358 [19%] aged 40-49 years, 906 [49%] aged 50-64 years, and 594 [32%] aged ≥65 years) completed the revised risk perception questions and were included in the analysis. Half of respondents thought breast density to be a greater risk than not having children (957 [52%]), having more than 1 alcoholic drink per day (975 [53%]), or having a prior breast biopsy (867 [48%]). Most respondents felt breast density was a lesser risk than having a first-degree relative with breast cancer (1706 [93%]) or being overweight or obese (1188 [65%]). Of the 61 women who were interviewed, 6 (10%) described breast density as contributing to breast cancer risk, and 43 (70%) emphasized family history as a breast cancer risk factor. Of the interviewed women, 17 (28%) stated they did not know whether it was possible to reduce their breast cancer risk.Conclusions and RelevanceIn this qualitative study of women of breast cancer screening age, family history was perceived as the primary breast cancer risk factor. Most interviewees did not identify breast density as a risk factor and did not feel confident about actions to mitigate breast cancer risk. Comprehensive education about breast cancer risks and prevention strategies is needed.

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Breast cancer risk characteristics of women undergoing whole‐breast ultrasound screening versus mammography alone

Sprague

Ichikawa

Eavey

et al. 2023

Cancer

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Background There are no consensus guidelines for supplemental breast cancer screening with whole‐breast ultrasound. However, criteria for women at high risk of mammography screening failures (interval invasive cancer or advanced cancer) have been identified. Mammography screening failure risk was evaluated among women undergoing supplemental ultrasound screening in clinical practice compared with women undergoing mammography alone. Methods A total of 38,166 screening ultrasounds and 825,360 screening mammograms without supplemental screening were identified during 2014–2020 within three Breast Cancer Surveillance Consortium (BCSC) registries. Risk of interval invasive cancer and advanced cancer were determined using BCSC prediction models. High interval invasive breast cancer risk was defined as heterogeneously dense breasts and BCSC 5‐year breast cancer risk ≥2.5% or extremely dense breasts and BCSC 5‐year breast cancer risk ≥1.67%. Intermediate/high advanced cancer risk was defined as BCSC 6‐year advanced breast cancer risk ≥0.38%. Results A total of 95.3% of 38,166 ultrasounds were among women with heterogeneously or extremely dense breasts, compared with 41.8% of 825,360 screening mammograms without supplemental screening (p < .0001). Among women with dense breasts, high interval invasive breast cancer risk was prevalent in 23.7% of screening ultrasounds compared with 18.5% of screening mammograms without supplemental imaging (adjusted odds ratio, 1.35; 95% CI, 1.30–1.39); intermediate/high advanced cancer risk was prevalent in 32.0% of screening ultrasounds versus 30.5% of screening mammograms without supplemental screening (adjusted odds ratio, 0.91; 95% CI, 0.89–0.94). Conclusions Ultrasound screening was highly targeted to women with dense breasts, but only a modest proportion were at high mammography screening failure risk. A clinically significant proportion of women undergoing mammography screening alone were at high mammography screening failure risk.

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Patient-Reported Breast Density Awareness and Knowledge after Breast Density Legislation Passage

Cited by 26 publications

References 15 publications

“You probably can’t feel as safe as normal women”: Hispanic women’s reactions to breast density notification

“You probably can’t feel as safe as normal women”: Hispanic women’s reactions to breast density notification

Perceptions of Breast Cancer Risks Among Women Receiving Mammograph Screening

Breast cancer risk characteristics of women undergoing whole‐breast ultrasound screening versus mammography alone

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