Low-Dose Chest CT-Participating in the Rise of Breast Density Awareness

Introduction: There is a strong correlation between CT and mammographic assessment of breast density. The purpose of this study was to assess whether women enrolled in the low-dose CT (LDCT) scan lung cancer screening program and had dense breasts on their CT scan were aware of their breast density, to confirm the correlation of CT and mammographic breast density, and to determine the utilization rates of supplemental screening. Methods: Participants were English-speaking women with dense breasts identified on LDCT done through the International Early Lung Cancer Action Program (I-ELCAP). All signed consent. Participants completed the I-ELCAP Dense Breast Questionnaire addressing patients' awareness and knowledge of breast density. Mammogram reports in the electronic medical record were analyzed for breast density category. Discrepant cases, i.e., where mammogram and LDCT dense breast density categories differed, were reviewed by an expert radiologist. Results: Most patients, 78/88 (89%), knew they had dense breasts. More than half of the participants, 56/88 (64%), did not receive additional testing. The CT and mammogram reported density was concordant in 52/60 (87%) of cases. All the discordant cases differed by one category-the mammograms were reported as having "scattered fibroglandular elements." Re-review of mammograms confirmed they were not dense in 5/8, and images were not available for 3/8. Conclusion: The lack of additional testing in those with documented dense breasts suggests weak adherence to recommendations and the potential for enhanced education about the potential benefits of supplemental screening. Additional education concerning breast density determination on CT relative to mammography may be useful.