Do breast density reporting laws help keep women informed?

Breast density reporting laws now exist in 28 states, but do women in those states know what, exactly, it means if an exam reveals they have dense breasts?

According to a recent study published in the Journal of the American College of Radiology, a majority of women in states with such laws do not know specific details about breast density and what it can mean for a woman’s health if she has dense breasts.

Lead author Jennifer A. Harvey, MD, of the University of Virginia in Charlottesville, Virginia, and colleagues surveyed more than 1,000 women ages 35 to 70 in 2013, asking them what they know about breast density and its effect on a woman’s health. All women lived in Virginia, one of the states where it is currently a requirement for patients to be notified if it is discovered they have dense breasts. The Virginia bill went into effect on July 1, 2012.

Harvey et al. explained the care they took when identifying women to interview for the study.

“The sampling frame for the study included both landline and cellular telephones, increasing the effectiveness in reaching minorities and women of lower income, who are more likely to have only cell phones,” the authors wrote. “Virginia’s mandatory breast density notification law was in place for a year before the study was undertaken, so this important background variable was held constant for all women in the study. The data reported here therefore give a new and clearer picture of the state of knowledge about breast density among the broad population of women subject to current breast cancer screening recommendations.”

Overall, 25 percent of respondents answered that they had heard of the relationship between breast density and breast cancer risk. Of the women included in that 25 percent, 85 percent knew that dense breasts made it harder for tumors to be detected, and 54 percent of respondents knew “a woman with dense breasts would have a higher risk of breast cancer.”

“The results thus indicate that the relationship between breast density and lower sensitivity of mammography is more familiar to women than the link between density and cancer risk, but the great majority of women are unfamiliar with (or unclear on) either relationship,” the authors wrote.

One statistic that stood out from the team’s research was that, when asked about risk factors for breast cancer, less than 1 percent of respondents specifically mentioned breast density. Twenty-one other risk factors were mentioned more frequently.

“The movement to notify women about their breast density assumes that, given better information, women will make better choices about their breast health,” the authors wrote. “The study results show, however, that merely informing a woman about her breast density is not enough information in itself. The results point to a need for much broader efforts to raise awareness among women of what breast density implies for their cancer risk and their choice of screening practices.”

Imaging leaders looking for more positive news will be happy to know that, according to the team’s data, nine out of 10 women knew breast imaging could be used to determine breast density.

Harvey and colleagues noted that their study did have limitations. For instance, they said comparing results in Virginia with results from a state with no reporting law in place would have been beneficial.