Researchers identify misperceptions surrounding breast density across race/ethnicity and health literacy levels

Date:
March 14, 2022
Source:
Boston University School of Medicine
Summary:
Having dense breasts (more fibroglandular tissue than fatty tissue,
as visualized on a mammogram) reduces the sensitivity of mammography
by masking breast cancers and carries a 1.6- to 2.0-fold increased
independent risk for breast cancer. To inform women about these
risks, 38 U.S. states and the federal government have enacted
legislation requiring a written dense breast notification (DBN)
of a patient's breast density after a mammogram, but there still
is limited evidence about what breast density means, and what the
implications are, to women. According to a new study, while women
are receiving these notifications about their breast density, not
all recipients are fully understanding what they mean in terms of
future health implications. Boston University School of Medicine
researchers suggest that knowledge about breast density and its
associated risks is partly linked to women's race/ethnicity and
health literacy.



FULL STORY ========================================================================== Having dense breasts (more fibroglandular tissue than fatty tissue,
as visualized on a mammogram) reduces the sensitivity of mammography
by masking breast cancers and carries a 1.6- to 2.0-fold increased
independent risk for breast cancer. To inform women about these risks, 38
U.S. states and the federal government have enacted legislation requiring
a written dense breast notification (DBN) of a patient's breast density
after a mammogram, but there still is limited evidence about what breast density means, and what the implications are, to women.


========================================================================== According to a new study, while women are receiving these notifications
about their breast density, not all recipients are fully understanding
what they mean in terms of future health implications. Boston University
School of Medicine researchers suggest that knowledge about breast density
and its associated risks is partly linked to women's race/ethnicity and
health literacy.

"Our findings, together with prior reports suggest that DBNs alone
are not adequately educating women, suggest that development of future notifications warrants further refinement and testing," says corresponding author Nancy Kressin, PhD, professor of medicine at BUSM.

To assess women's knowledge about breast density after receiving
a notification, the researchers conducted a telephone survey and
interviews among a racially/ethnically and health literacy level diverse sample. Although most women responded correctly that breast density is
related to the amount of fatty versus connective tissue, the researchers observed significant variations by women's race/ ethnicity, whereby Non-Hispanic White women were less likely to respond correctly than Non-Hispanic Black women.

Only 47 percent of women correctly indicated that having dense breasts increases one's risk of breast cancer; women with low health literacy
were more often correct. Fifty-eight percent of women correctly
indicated that breast density is not related to touch, with higher
accuracy among non-Hispanic white women and those with greater health
literacy. Eighty-seven percent of women recognized that breast density
is identified visually via mammogram, with no significant differences
in responses by race/ethnicity or health literacy.

Qualitative results revealed additional dimensions of understanding:
Some women incorrectly reported that density could be felt, or dense
breasts were lumpier, thicker, or more compacted; others identified
''dense'' tissue as fatty.

Interpretations of risk included that breast density was an early form
of breast cancer.

"The ultimate goal of DBNs is to educate women about breast density,
to guide their future decisions about breast cancer screening. Thus,
in-depth characterization of women's knowledge after receiving a DBN
can help ensure that future health communications are accessible and understandable to all recipients," adds Kressin.

These findings appear online in the Journal of Women's Health.

Funding for this study was provided by a grant from the American Cancer
Society (133017-RSG-19-085-01-CPHPS); C.M.G. was also supported by the
National Cancer Institute (1K07CA221899).

P.J.S., Co-author on an UpToDate article on Breast density and screening
for breast cancer, for which she receives royalties.


========================================================================== Story Source: Materials provided by
Boston_University_School_of_Medicine. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Nancy R. Kressin, Jolie B. Wormwood, Tracy A. Battaglia, Ariel D.

Maschke, Priscilla J. Slanetz, Magdalena Pankowska, Christine
M. Gunn.

Women's Understandings and Misunderstandings of Breast Density and
Related Concepts: A Mixed Methods Study. Journal of Women's Health,
2022; DOI: 10.1089/jwh.2021.0343 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/03/220314142034.htm

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