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What do women really know about breast density?

by Gus Iversen, Editor in Chief | July 06, 2020
Women's Health
From the July 2020 issue of HealthCare Business News magazine

HCB News: What can healthcare providers do to ensure their own patients understand what breast density means for their health?
KS: One of the things we recommend is that providers learn more about breast density in combination with other risk factors for breast cancer and screening options so that they can explore this with their patients. The BCSC has developed a web-based tool to calculate 5-year breast cancer risk that is available to both providers and patients, which could be useful in learning more [https://tools.bcsc-scc.org/BC5yearRisk/].

HCB News: Are there other opportunities or avenues for improving breast density education?

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KS: There is at least one tool that was tested in a randomized controlled trial, where one group just got the density notification letter after a mammogram and the other group got the notification letter along with a short 3-5 minute video based on the woman’s risk. What is clever is that there were four different versions of the video based on a woman’s risk using the BCSC risk calculator so the videos were somewhat personalized to them. And they showed that this helped improve women’s knowledge about their personal risks and breast density and the likelihood that they talked to their PCP about screening options. It was only tested with women who speak English and most of the women had a college education or higher, but if something like this could be developed and tested with women from different racial and socio-economic backgrounds and in different languages it would seem like a fantastic tool for both women and their providers to facilitate the conversation.

HCB News: Why is this topic so important?
KS: I personally didn’t know much about this topic in the past and very recently learned that I had very dense breasts in the past because I happened to be looking at some old medical records and saw it there. I don’t have any other risk factors and have had no issues related to screening, but it was kind of a shock to me that no one ever told me about this. And I happened to be living in two states in the past several years that do not have notification laws. Maybe I would have done the same thing I have been doing, but it would have been nice to know that this was an informed decision rather than just me fitting in screening every 18 months or so.

Although there are still questions about breast density and the best screening protocols based on the combination of risk factors, there really shouldn’t be cases like mine where women don’t have this information for their own decisions and conversations with their providers. If we can change this and figure out how to best inform women, hopefully it will lead to screening based on risks rather than screening based on fear or lack of knowledge.

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