Despite longstanding breast density laws, patients remain confused and misinformed

Breast density laws have been on the books since 2009, with state’s increasingly joining the upward trend. But a new survey found many remain confused and misinformed about such legislation.

Five Boston researchers surveyed 1,000 women. Of the 338 who returned the survey, a majority (61.2 percent) were surprised to receive a breast density notification letter, and 90 percent were unaware of newly implemented legislation, according to an August 16 Academic Radiology study.

Density legislation has been around for nearly 10 years with Massachusetts implemented its own in 2015, but “confusion and misinformation about breast density persists among women receiving mammography screening,” wrote Randy C. Miles, MD, with Massachusetts General Hospital in Boston, and colleagues.

The authors found 55 percent of women self-reported having dense breasts and 61 percent of that group believed their individual breast density increased breast cancer risk. Conversely, 60 percent of women with non-dense breasts responded that their density did not increase breast cancer risk.

Approximately 90 percent of women signaled a preference to receive density notification, but as the authors pointed out, Massachusetts’ practice of mailing physical letters may not be the best method to do so.

“These findings suggest that mailed written notification may not be sufficient in educating women about their breast density,” they argued. “While most women are interested in being informed about their breast density, the long-term impact of mailed written notification of breast density on patient anxiety and confusion must be determined.”

This is bolstered by the seven percent of women who remained unaware of their own breast density upon receiving a detailed breast density notification letter. However, authors wrote that providers must share in the blame.

A survey of primary care doctors in Massachusetts revealed although nearly 80 percent knew of breast density legislation, only half were comfortable answering patient questions on the topic. And most were unable to identify the eight components of the state’s law.

Miles et al. suggested discussing the topic with a healthcare provider or navigator in the breast imaging center may help to limit notification anxiety.

The authors said the survey population and small sample size may not adequately represent the entire U.S. They said more must be done to properly educate patients about breast density.

“Informed- and shared-decision making between patients and providers, who order mammography examinations, may help to alleviate some of these issues,” they concluded. ”Thus, innovative, educational tools targeting both groups may be required to improve communication about breast density and subsequent breast care management.