Knowledge and Perception of Breast Density, Screening Mammography, and Supplemental Screening: in Search of “Informed”

Schifferdecker, Karen E.; Kaplan, Celia P.; Kerlikowske, Karla; Buist, Diana S.M.; Henderson, Louise M.; Johnson, Dianne; Jaworski, Jill; Jackson-Nefertiti, Gloria; Ehrlich, Kelly; Marsh, Mary W.; Vu, Lisa; Onega, Tracy; Wernli, Karen J.

doi:10.1007/s11606-019-05560-z

Cited by 23 publications

(22 citation statements)

References 23 publications

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“…Intermediate risk women (12-20% lifetime risk) and those with extremely dense breast density may be offered supplemental screening with breast ultrasound [25,26]. Unfortunately, not all women have access to or even awareness of the value and availability of this additional imaging [27,28].…”

Section: The Current State Of Breast Imagingmentioning

confidence: 99%

Cone-Beam Breast Computed Tomography: Time for a New Paradigm in Breast Imaging

O’Connell

Marini

Kawakyu-O’Connor

2021

JCM

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It is time to reconsider how we image the breast. Although the breast is a 3D structure, we have traditionally used 2D mammography to perform screening and diagnostic imaging. Mammography has been continuously modified and improved, most recently with tomosynthesis and contrast mammography, but it is still using modifications of compression 2D mammography. It is time to consider 3D imaging for this 3D structure. Cone-beam breast computed tomography (CBBCT) is a revolutionary modality that will assist in overcoming the limitations of current imaging for dense breast tissue and overlapping structures. It also allows easy administration of contrast material for functional imaging. With a radiation dose on par with diagnostic mammography, rapid 10 s acquisition, no breast compression, and true high-resolution isotropic imaging, CBBCT has the potential to usher in a new era in breast imaging. These advantages could translate into lower morbidity and mortality from breast cancer.

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Section: The Current State Of Breast Imagingmentioning

confidence: 99%

Cone-Beam Breast Computed Tomography: Time for a New Paradigm in Breast Imaging

O’Connell

Marini

Kawakyu-O’Connor

2021

JCM

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“…In-person focus group participants had a mean age of 59 years (range 44–75), were predominantly Black (73%, n = 32), and 48% (n = 21) had ≤12 years of education ( Table 1 ). BCSC stakeholders volunteered from a pool of 48 women who were predominantly White (70%), 49% had at least a bachelor’s degree, with a mean age of 58 years (range 40–80) [ 20 ]. Patients reported that our brochure was easy to read (n = 41, 93.2%), understand (n = 42, 95.4%), and made them ‘feel less worried about dense breasts’ (n = 34, 77.3%) ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Subsequently, 13 Breast Cancer Surveillance Consortium (BCSC) patients and researcher stakeholders provided feedback in an online closed discussion about our brochure as well as a flyer developed by BCSC. This discussion was conducted as part of ongoing stakeholder engagement [20]. They were asked what they liked about the brochure and what they would want to change.…”

Section: Focus Group Data Collectionmentioning

confidence: 99%

Evaluation of existing patient educational materials and development of a brochure for women with dense breasts

et al. 2020

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Objectives: In this pilot study, we developed and assessed acceptability of a brochure for women with dense breasts. Material and methods: We measured Flesch-Kincaid Readability of 22 existing breast density educational materials. We then developed a brochure and tested it in two populations of women: 44 safety net hospital patients and 13 Breast Cancer Surveillance Consortium stakeholders. Results: Average grade score of existing materials was 10.0 (range: 5.5e12.7). Our brochure had a grade score of 5.9, and patients reported it was easy to understand. Conclusion: Our plain language brochure could improve patient understanding following mandatory dense breast notification.

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“…We observed no differences in annual mammography maintenance between the intervention and control arms. Some women mistrust mammography in the current climate of increased breast density awareness because of concerns about mammography’s ability to find breast cancer ( 34 ). Hence, our intervention had the intended impact of providing balanced education about breast density and cancer risk that did not further alarm women about inaccuracies of mammograms while reassuring that continuing to screen with mammography was their first line of detection.…”

Section: Discussionmentioning

confidence: 99%

“…Further, women needed to access online information to participate in the study. In general public, breast density awareness remains low ( 34 ), specifically among women of color and without college education ( 41 ). The effectiveness of our intervention in other healthcare settings and more heterogenous populations should be tested prior to widespread implementation and dissemination.…”

Section: Discussionmentioning

confidence: 99%

Effect of Personalized Breast Cancer Risk Tool on Chemoprevention and Breast Imaging: ENGAGED-2 Trial

Wernli

Knerr

et al. 2021

JNCI Cancer Spectrum

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Background Limited evidence exists about how to communicate breast density-informed breast cancer risk to women at elevated risk to motivate cancer prevention. Methods We conducted a randomized controlled trial evaluating a web-based intervention incorporating personalized breast cancer risk, information on chemoprevention, and values clarification on chemoprevention uptake vs active control. Eligible women aged 40-69 years with normal mammograms and elevated 5-year breast cancer risk were recruited from Kaiser Permanente Washington from February 2017 to May 2018. Chemoprevention uptake was measured as any prescription for raloxifene or tamoxifen within 12 months from baseline in electronic health record pharmacy data. Secondary outcomes included breast magnetic resonance imaging (MRI), mammography use, self-reported distress, and communication with providers. We calculated unadjusted odds ratios (ORs) using logistic regression models and mean differences using analysis of covariance models with 95% confidence intervals (CIs) with generalized estimating equations. Results We randomly assigned 995 women to the intervention arm (n = 492) or control arm (n = 503). The intervention (vs control) had no effect on chemoprevention uptake (OR = 1.04, 95% CI = 0.07 to 16.62). The intervention increased breast MRI use (OR = 5.65, 95% CI = 1.61 to 19.74) while maintaining annual mammography (OR = 0.98, 95% CI = 0.75 to 1.28). Women in the intervention (vs control) arm had 5.67-times higher odds of having discussed chemoprevention or breast MRI with provider by 6 weeks (OR = 5.67, 95% CI = 2.47 to 13.03) and 2.36-times higher odds by 12 months (OR = 2.36, 95% CI = 1.65 to 3.37). No measurable differences in distress were detected. Conclusions A web-based, patient-level intervention activated women at elevated 5-year breast cancer risk to engage in clinical discussions about chemoprevention, but uptake remained low.

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Knowledge and Perception of Breast Density, Screening Mammography, and Supplemental Screening: in Search of “Informed”

Cited by 23 publications

References 23 publications

Cone-Beam Breast Computed Tomography: Time for a New Paradigm in Breast Imaging

Cone-Beam Breast Computed Tomography: Time for a New Paradigm in Breast Imaging

Evaluation of existing patient educational materials and development of a brochure for women with dense breasts

Effect of Personalized Breast Cancer Risk Tool on Chemoprevention and Breast Imaging: ENGAGED-2 Trial

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