New research by experts at the University of Sydney shows that breast density notification is leaving some women confused and anxious about their breast health.<\/p>\n
The\u00a0notification\u00a0program\u00a0is\u00a0designed to\u00a0advise\u00a0women that\u00a0their breast\u00a0density is a risk for developing cancer, as well as highlighting\u00a0that dense breasts could prevent cancer from being\u00a0observed\u00a0on a mammogram.\u00a0<\/p>\n
Breast\u00a0density notification is\u00a0currently\u00a0being rolled out across Australia,\u00a0and is already mandatory in the US,\u00a0but until now there has been no\u00a0high-quality\u00a0research into the impact of these notifications on women.\u00a0<\/p>\n
Lead author\u00a0of the\u00a0British\u00a0Medical\u00a0Journal\u00a0study,\u00a0Dr Brooke Nickel\u00a0from the\u00a0School of Public Health, said:\u00a0“Breast density\u00a0notification\u00a0is based on\u00a0the premise that giving\u00a0women\u00a0information will empower them\u00a0to\u00a0make individual choices about their health.\u00a0<\/p>\n
“In theory this is a\u00a0really\u00a0good\u00a0thing\u00a0but what we found in practice was that breast density notification made women more confused and anxious about their\u00a0breast\u00a0health.\u00a0Women also did not feel more informed.”\u00a0<\/p>\n
Estimates suggest that between 25 and 40 percent\u00a0of\u00a0women have denser breast tissue which can increase the risk of developing cancer and make it harder for cancers to be detected\u00a0through a\u00a0mammogram.\u00a0<\/p>\n
For women with denser breasts,\u00a0further\u00a0screening via ultrasound, MRI and contrast-enhanced mammography has been shown to detect cancers. However, most of these\u00a0additional\u00a0screening methods\u00a0mean out-of-pocket costs for women, and\u00a0the long-term benefits in terms\u00a0of mortality rates, as well as\u00a0unintended adverse\u00a0consequences,\u00a0such as widening health inequality,\u00a0are not well-evidenced.\u00a0<\/p>\n
Carrying out the research\u00a0<\/strong><\/p>\n To understand the impact of breast density notification, the researchers\u00a0carried out a randomised control trial\u00a0involving 2401 women\u00a0across 13\u00a0BreastScreen\u00a0sites in Queensland\u00a0between September 2023 and July 2024.\u00a0<\/p>\n As part of the\u00a0randomised\u00a0controlled\u00a0trial, women identified as having dense breasts\u00a0received one of three\u00a0outcomes:\u00a0<\/p>\n a notification of breast density in their screening results letter plus a\u00a0leaflet with\u00a0additional\u00a0information about\u00a0having denser\u00a0breasts;\u00a0<\/p>\n
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<\/p>\n notification of breast density in the results letter plus a link to online video-based health literacy-sensitive information;\u00a0<\/p>\n
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<\/p>\n no notification of breast density in their results letter\u00a0(control group).\u00a0<\/p>\n
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\n<\/ul>\n Significantly,\u00a011.5 percent and 9 percent of the\u00a0two\u00a0intervention groups respectively reported\u00a0feeling confused\u00a0after\u00a0receiving a breast density notification\u00a0alongside a normal screening result, compared to only 2.7 percent of women in the control group.\u00a0<\/p>\n Levels of\u00a0anxiousness\u00a0among the participants\u00a0about what to do\u00a0regarding\u00a0their breast health\u00a0were also higher in the intervention groups, rising to 20.8 percent\u00a0(outcome 1)\u00a0and 20.5 percent\u00a0(outcome 2)\u00a0respectively, compared to the 18 percent of women in the control group.\u00a0<\/p>\n Both notified groups also had significantly higher intention\u00a0to talk to their GP about their screening results\u00a0\u2013\u00a022.8\u00a0percent and\u00a019.4\u00a0percent respectively\u00a0\u2013\u00a0compared with\u00a0only 12.9 percent in the control group.\u00a0<\/p>\n Dr Nickel\u00a0said: “Creating confusion\u00a0and worry\u00a0for women about their breast health is not a good outcome. And while it might seem positive that notified women want to seek further advice from their GP, there\u00a0is\u00a0currently\u00a0limited\u00a0evidence-based\u00a0clinical pathways that GPs can offer, with most of the\u00a0suggested recommendations\u00a0leaving women with out-of-pocket costs.\u00a0<\/p>\n “Internationally,\u00a0we\u00a0encourage\u00a0governments to\u00a0consider gathering\u00a0additional data on beneficial and equitable clinical pathways and\u00a0to\u00a0plan the provision of breast density information\u00a0carefully\u00a0to ensure that\u00a0the\u00a0benefits\u00a0of breast density notification\u00a0outweigh potential harms\u00a0for all women.”\u00a0<\/p>\n Source:<\/p>\n Journal reference:<\/p>\n
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