Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Associate Director of the Belkin Breast Health Center, Boston Medical Center, and Director, Women's Health Group, Boston Medical Center.
J Am Coll Radiol. 2021 May;18(5):685-695. doi: 10.1016/j.jacr.2020.11.012. Epub 2020 Dec 25.
Understanding whether states' breast density notifications are associated with desired effects, or disparities, can inform federal policy. We examined self-reported receipt of personal breast density information, breast density discussions with providers, knowledge about density's masking effect, and association with increased breast cancer risk by state legislation status and women's sociodemographic characteristics.
Cross-sectional observational population-based telephone survey of women aged >40 years who underwent mammography within prior 2 years, had no history of breast cancer, and had heard the term "breast density."
Among 2,306 women, 57% received personal breast density information. Multivariate regression models adjusted for covariates indicated that women in notification states were 1.5 times more likely to receive density information, and older Black and Asian women of lower income and lower health literacy were less likely. Overall, only 39% of women discussed density with providers; women in notification states were 1.75 times as likely. Older and Asian women were less likely to have spoken with providers; women with high literacy or prior biopsy were more likely. State legislation status was not associated with differences in density knowledge, but Hispanic women and women of lower income or low health literacy had less knowledge regarding density's masking effects; older women were more knowledgeable. Hispanic women and women of lower income or low health literacy were more likely, and middle-aged women less likely, to recognize increased breast cancer risk.
Some positive effects were observed, but sociodemographic disparities suggest tailoring of future breast density communications for specific populations of women to ensure equitable understanding.
了解各州的乳房密度通知是否与预期效果或差异相关，这可以为联邦政策提供信息。我们研究了自我报告收到个人乳房密度信息、与提供者讨论乳房密度、了解密度的掩盖作用以及与州立法状况和妇女社会人口统计学特征相关的乳腺癌风险增加的情况。
对过去 2 年内接受过乳房 X 光检查、无乳腺癌病史且听说过“乳房密度”一词的年龄>40 岁的妇女进行了基于人群的横断面观察性电话调查。
在 2306 名妇女中，57%的人收到了个人乳房密度信息。调整了协变量的多变量回归模型表明，通知州的妇女获得密度信息的可能性是未通知州的 1.5 倍，而年龄较大的黑人女性和收入较低、健康素养较低的亚裔女性获得信息的可能性较低。总体而言，只有 39%的妇女与提供者讨论了密度问题；通知州的妇女的可能性是未通知州的 1.75 倍。年龄较大的女性和亚裔女性与提供者交谈的可能性较小；文化程度较高或有过活检的妇女更有可能与提供者交谈。州立法状况与密度知识的差异无关，但西班牙裔妇女和收入较低或健康素养较低的妇女对密度的掩盖作用的了解较少；年龄较大的妇女更了解这一点。西班牙裔妇女和收入较低或健康素养较低的妇女更有可能认识到乳腺癌风险增加，而中年妇女则不太可能认识到这一点。
观察到了一些积极的影响，但社会人口统计学差异表明，需要为特定的妇女群体量身定制未来的乳房密度沟通，以确保公平的理解。
