Dense-breast patients nearly 10 times more likely to pursue ABUS after 2-part notification

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Image: University of Kansas/American Journal of Roentgenology

Following screening mammography that turns up nothing, women with dense breast tissue are much more likely to pursue additional imaging with automated breast ultrasound (ABUS) when two things happen: their radiologists inform them of their tissue density and encourage them to consider the secondary exam because of it.

In the study behind the findings, the effect was further magnified—greatly so—when the patient received a phone call on top of a letter.

The American Journal of Roentgenology published the study online Oct. 18.

Allison Aripoli, MD, of the University of Kansas and colleagues reviewed communications with, and subsequent actions taken by, 3,012 women with dense breast tissue who had who had normal mammography results.

They considered type of results letter, notification method and sociodemographic characteristics in relation to subsequent ABUS activity.

The team found that patients notified by mail of their high tissue density and told that they might benefit from ABUS were 9.91 times more likely to act on the suggestion than patients who received neither density notification nor ABUS information.

More striking yet, compared with a similarly sized control group of women who did not undergo ABUS, some 86.9 percent of patients returned for the additional imaging if they received a results letter indicating breast density combined with a courtesy phone call.

In their discussion, Aripoli et al. state that their findings might be especially pertinent to practices “considering investing in supplemental screening technology or looking for a greater return on investment.”

Although there are currently no standardized guidelines for the use of ABUS in women with dense breast tissue and negative mammograms, the authors add, studies have shown that ultrasound may indeed increase cancer detection rates in these women.

“[I]t is critical for radiologists to work with referring specialists and primary care providers to develop evidence-based guidelines or recommendations for when supplemental screening is advisable and which methods are most effective,” they write. “Recognition of the factors affecting screening behaviors will be an important consideration should screening ultrasound be offered as a supplemental imaging modality for women with dense breasts.”