Regional survey underscores need for more radiologist education on breast density

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 - breast density search patterns
(a) Lesion overlying the fibroglandular dense tissue in a low-density mammogram; (b) lesion outside the fibroglandular dense tissue in a low-density mammogram.
Source: Academic Radiology 2014;21:1386–1393

Many practicing radiologists share the general public’s sense of befuddlement over state-level breast density legislation and its implications for patient care, at least in New England, according to a study published online May 8 in Academic Radiology.

Ana Lourenco, MD, of Brown University in Providence, R.I., and colleagues made the finding upon surveying 523 members of the New England Roentgen Ray Society.

Ninety-six members responded, 73 percent of whom practice in Connecticut, Massachusetts, Rhode Island or Vermont, all of which have breast density laws on the books.

(Maine suggests notification but does not require it, while New Hampshire has no official policy on the matter.)

The respondents said breast density notification improves understanding of the effect of breast density on mammographic sensitivity for patients (74 percent) as well as providers (66 percent).

At the same time, a strong majority—69 percent—said such notification increases patient anxiety.

The researchers additionally found considerable variability in radiologists’ knowledge of the relative risk of breast cancer when comparing breasts of different density.

In their discussion, the authors note their survey’s confirmation of previous studies suggesting that practicing radiologists need more education in three areas—the content of breast density laws in their respective states, the clinical importance of dense breast tissue and the optimal management of women with dense tissue.

“With limited healthcare resources, it is critical that we optimize care using evidence-based guidelines,” Lourenco et al. write. “Although the goal is early detection, the trade-offs must be reasonable to minimize anxiety and the risk of false positives. Breast density is an established risk factor for breast cancer, but it is important to keep this risk factor in perspective when recommending additional screening.”