New study examining women’s breast density knowledge suggests opportunities for improvement

LEBANON, NH –  Breast density is one factor in assessing a person’s risk of developing breast cancer. Existing state breast density notification laws have increased breast density awareness among patients and providers, but clinical records had not been incorporated in studies to confirm accuracy of personal breast density knowledge. A research team at Dartmouth Cancer Center worked with the Breast Cancer Surveillance Consortium (BCSC) to both survey women and incorporate their clinical records from 15 mammography facilities across three states to find out how much women knew about their own breast density.

The study, “Breast Density Knowledge in a Screening Mammography Population Exposed to Density Notification,” recently published online in the Journal of the American College of Radiology (JACR), found that while breast density knowledge may be increasing due to existing state laws, there is still room for improvement, and that clinicians need tools to engage with women in understanding their personal breast cancer risks and screening options.

“Particular consideration should be given to those with lower literacy in the design of those tools,” says lead author Rebecca Smith, MS. “There may also be benefit to standardized breast density communications for all women—women with dense and non-dense breasts—as opposed to just women with dense breasts.”

The team set out to measure accuracy and predictors of women’s breast density knowledge in a nationally representative sample of women eligible for breast cancer screening who had not had a previous breast cancer. They also examined women’s understanding of the implications of breast density and breast density’s impact on future screening intentions.

The majority (76%) of women with dense breasts correctly knew their breast density, while most women with non-dense breasts did not (14%). About one-third of women with non-dense breasts believed they had dense breasts and women who believed they had dense breasts were more likely than women who believed they had non-dense breasts to want supplemental screening. Density reporting to all women, compared to only women with dense breasts, was associated with an increased chance of accurate breast density knowledge for women with non-dense breasts. Lower education was associated with a lower chance of correctly knowing one’s own density.

“Health care providers will need decision support tools to keep informed of evolving evidence on who may benefit from supplemental screening and for engaging women in shared decision making,” says Smith. “Density notifications should be tailored and accessible to a wide range of literacy levels., There may be benefit to standardized breast density communications for both women with dense and non-dense breasts.”

Anna Tosteson, ScD, the study’s senior author, notes “Our study’s findings are important for policy makers to consider when designing pending national breast density notification regulations.”

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Rebecca Smith, MS, is a PhD student at Dartmouth in The Dartmouth Institute for Health Policy and Clinical Practice doctoral program and previously was a Project Manager in The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth.

Anna N.A. Tosteson, ScD, is the Associate Director for Population Sciences at Dartmouth Cancer Center, the James J. Carroll Professor of Oncology and a Professor in The Dartmouth Institute for Health Policy and Clinical Practice, and the Departments of Medicine and of Community and Family Medicine, Geisel School of Medicine at Dartmouth.

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About Dartmouth Cancer Center

Dartmouth Cancer Center combines advanced cancer research at Dartmouth College’s Geisel School of Medicine with the highest level of high-quality, innovative, personalized, and compassionate patient-centered cancer care at Dartmouth Hitchcock Medical Center, as well as at regional, multi-disciplinary locations and partner hospitals throughout NH and VT. Dartmouth Cancer Center is one of only 51 National Cancer Institute-designated Comprehensive Cancer Centersin the nation, the result of an outstanding collaboration between Dartmouth Hitchcock Medical Center, New Hampshire’s only academic medical center, and Dartmouth College. Celebrating its 50^th anniversary in 2022, Dartmouth Cancer Center remains committed to excellence, outreach and education, and strives to prevent and cure cancer, enhance survivorship and to promote cancer health equity through its pioneering interdisciplinary research. Each year the Dartmouth Cancer Center schedules 61,000 appointments seeing nearly 4,000 newly diagnosed patients, and currently offers its patients more than 100 active clinical trials. 

About the Geisel School of Medicine

Founded in 1797, the Geisel School of Medicine at Dartmouth strives to improve the lives of the communities it serves through excellence in learning, discovery, and healing. The Geisel School of Medicine is renowned for its leadership in medical education, healthcare policy and delivery science, biomedical research, global health, and in creating innovations that improve lives worldwide. As one of America’s leading medical schools, Dartmouth’s Geisel School of Medicine is committed to training new generations of diverse leaders who will help solve our most vexing challenges in healthcare.

About Dartmouth Health

A national leader in healthcare, Dartmouth Health is New Hampshire’s only academic health network and the state’s largest private employer, serving a population of 1.9 million across northern New England. Dartmouth Health and our nearly 2,000 providers are all deeply committed to serving the healthcare needs of our communities and to providing each of our patients with exceptional, personal care. Dartmouth Hitchcock Medical Center is consistently named the #1 hospital in New Hampshire by U.S. News & World Report. Dartmouth Health includes the Dartmouth Cancer Center, one of only 51 NCI-designated Comprehensive Cancer Centers in the nation; Dartmouth Health Children’s, which includes the state’s only children’s hospital; and member hospitals and clinics across the state. Through its historical partnership with Dartmouth and the Geisel School of Medicine, Dartmouth Health performs cutting-edge research and clinical trials, and trains nearly 400 medical residents and fellows annually.