The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire.
Associate Professor of Surgery, Director of the Vermont Breast Cancer Surveillance System, and Senior Epidemiologist at the Vermont Center on Behavior and Health, Department of Surgery and University of Vermont Cancer Center, University of Vermont, Burlington, Vermont.
J Am Coll Radiol. 2022 May;19(5):615-624. doi: 10.1016/j.jacr.2022.02.025. Epub 2022 Mar 24.
Women are increasingly informed about their breast density due to state density reporting laws. However, accuracy of personal breast density knowledge remains unclear. We compared self-reported with clinically assessed breast density and assessed knowledge of density implications and feelings about future screening.
From December 2017 to January 2020, we surveyed women aged 40 to 74 years without prior breast cancer, with a normal screening mammogram in the prior year, and ≥1 recorded breast density measures in four Breast Cancer Surveillance Consortium registries with density reporting laws. We measured agreement between self-reported and BI-RADS breast density categorized as "ever-dense" if heterogeneously or extremely dense within the past 5 years or "never-dense" otherwise, knowledge of dense breast implications, and feelings about future screening.
Survey participation was 28% (1,528 of 5,408), and 59% (896 of 1,528) of participants had ever-dense breasts. Concordance between self-report versus clinical density was 76% (677 of 896) among women with ever-dense breasts and 14% (89 of 632) among women with never-dense breasts, and 34% (217 of 632) with never-dense breasts reported being told they had dense breasts. Desire for supplemental screening was more frequent among those who reported having dense breasts 29% (256 of 893) or asked to imagine having dense breasts 30% (152 of 513) versus those reporting nondense breasts 15% (15 of 102) (P = .003, P = .002, respectively). Women with never-dense breasts had 6.3-fold higher odds (95% confidence interval:3.39-11.80) of accurate knowledge in states reporting density to all compared to states reporting only to women with dense breasts.
Standardized communications of breast density results to all women may increase density knowledge and are needed to support informed screening decisions.
由于州级密度报告法，女性对自身乳房密度的了解越来越多。然而，个人乳房密度知识的准确性仍不清楚。我们比较了自我报告和临床评估的乳房密度，并评估了对密度影响的认识以及对未来筛查的感受。
2017 年 12 月至 2020 年 1 月，我们调查了年龄在 40 至 74 岁之间、既往无乳腺癌、既往一年接受过正常筛查乳房 X 光检查且在有密度报告法的四个乳腺癌监测联合会注册中心有≥1 个记录的乳房密度测量值的女性。我们测量了自我报告和 BI-RADS 乳房密度之间的一致性，如果在过去 5 年内是不均匀或极度致密的，则归类为“始终致密”，否则归类为“从不致密”，测量对致密乳房影响的认识，以及对未来筛查的感受。
调查参与率为 28%（5408 名中的 1528 名），59%（1528 名中的 896 名）的参与者有致密乳房。在有致密乳房的女性中，自我报告与临床密度的一致性为 76%（896 名中的 677 名），在无致密乳房的女性中为 14%（632 名中的 89 名），而在无致密乳房的女性中，34%（632 名中的 217 名）报告说她们的乳房致密。与报告非致密乳房的女性相比，报告有致密乳房的女性中更频繁地希望进行补充筛查 29%（893 名中的 256 名）或想象自己有致密乳房 30%（513 名中的 152 名）（P<.003，P<.002）。与仅向致密乳房女性报告密度的州相比，向所有女性报告密度的州，报告无致密乳房的女性准确知识的可能性高 6.3 倍（95%置信区间：3.39-11.80）。
向所有女性标准化传递乳房密度结果可能会增加密度知识，并需要支持知情的筛查决策。
