Dense breast tissue poses up to four times higher risk of developing breast cancer, yet a recent study found that many women are unaware of the risks of breast density, with most of them believing family history to pose the greatest potential danger.
Dense breasts refers to breasts that are composed of more fibrous and glandular tissue compared with fatty tissue, and can be detected while undergoing a mammogram, reports The Independent.
The study, led by Dartmouth College, New Hampshire, and published in Jama Network Open, surveyed 1 858 women ages 40 to 76 from 2019 to 2020 who had recently undergone mammography, had no history of breast cancer, and had heard of breast density.
It assessed women’s understanding of breast density as a significant breast cancer risk compared with other well known risk factors, such as having a relative with breast cancer, being overweight or obese, drinking more than one alcoholic beverage per day, never having children, and having a prior breast biopsy.
Despite breast density being associated with a 1.2 to four times higher risk of developing breast cancer, according to the study, few women perceived breast density to be a strong personal risk factor. Instead, 93% of them saw family history as being the greatest risk, followed by 65% of women who said that being overweight or obese was a greater risk than breast density.
Of the 61 women who were interviewed, only six described breast density as contributing to breast cancer risk, although most of them correctly noted that breast density could make mammograms harder to read.
When asked about what they could take to reduce their breast cancer risk, roughly one-third said they weren’t sure if it were possible to reduce their breast cancer risk, or they were unaware of what actions they could take.
The American Cancer Society recommends women between 45 and 54 should get a mammogram every year, and those between 40 and 44 also have the option to start early screening, while those 55 and older can switch to a mammogram every alternative year if they choose to do so.
Nearly half of all women who are 40 and older and who have mammograms have dense breasts, per the National Cancer Institute.
While it is inherited, it can also be found in women who are younger, are taking hormone replacement therapy, or have a lower body weight.
While it can make it more difficult to interpret a mammogram, the newer type of mammogram – digital breast tomosynthesis – or 3D mammography – seems to be more helpful in women with dense breasts.
Study details
Perceptions of Breast Cancer Risks Among Women Receiving Mammograph Screening
Laura Beidler, Nancy Kressin, Jolie Wormwood, et al
Published in JAMA Network Open on 23 January 2023
Key Points
Question How do women perceive the breast cancer risk associated with breast density, and how do they plan to mitigate their risk?
Findings In this qualitative study of women aged 40 to 76, family history was perceived as the greatest risk factor for breast cancer. In interviews, few women perceived breast density as a risk factor, and one-third thought that they could not take any actions to reduce their breast cancer risk.
Meaning Despite laws that require women to be notified about breast density, women did not describe a strong understanding of the risk associated with breast density relative to other breast cancer risk factors.
Abstract
Importance
Breast density is an independent risk factor for breast cancer. Despite the proliferation of mandated written notifications about breast density following mammography, there is little understanding of how women perceive the relative breast cancer risk associated with breast density.
Objective
To assess women’s perception of breast density compared with other breast cancer risks and explore their understanding of risk reduction.
Design, Setting, and Participants
This mixed-methods qualitative study used telephone surveys and semistructured interviews to investigate perceptions about breast cancer risk among a nationally representative, population-based sample of women. Eligible study participants were aged 40 to 76 years, reported having recently undergone mammography, had no history of prior breast cancer, and had heard of breast density. Survey participants who had been informed of their personal breast density were invited for a qualitative interview. Survey administration spanned July 1, 2019, to April 30, 2020, with 2 306 women completing the survey. Qualitative interviews were conducted from February 1 to May 30, 2020.
Main Outcomes and Measures
Respondents compared the breast cancer risk associated with breast density with 5 other risk factors. Participants qualitatively described what they thought contributed to breast cancer risk and ways to reduce risk.
Results
Of the 2 306 women who completed the survey, 1 858 (166 [9%] Asian, 503 [27%] black, 268 [14%] Hispanic, 792 [43%] white, and 128 [7%] other race or ethnicity; 358 [19%] aged 40-49 years, 906 [49%] aged 50-64 years, and 594 [32%] aged ≥65 years) completed the revised risk perception questions and were included in the analysis. Half of respondents thought breast density to be a greater risk than not having children (957 [52%]), having more than one alcoholic drink per day (975 [53%]), or having a prior breast biopsy (867 [48%]). Most respondents felt breast density was a lesser risk than having a first-degree relative with breast cancer (1 706 [93%]) or being overweight or obese (1 188 [65%]). Of the 61 women who were interviewed, 6 (10%) described breast density as contributing to breast cancer risk, and 43 (70%) emphasised family history as a breast cancer risk factor. Of the interviewed women, 17 (28%) stated they did not know whether it was possible to reduce their breast cancer risk.
Conclusions and Relevance
In this qualitative study of women of breast cancer screening age, family history was perceived as the primary breast cancer risk factor. Most interviewees did not identify breast density as a risk factor and did not feel confident about actions to mitigate breast cancer risk. Comprehensive education about breast cancer risks and prevention strategies is needed.
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