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Impact of population based breast density notification: multisite parallel arm randomised controlled trial in
Brooke Nickel1,2, Nick Ormiston-Smith3, Erin Cvejic4
1Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, NSW, Australia brooke.nickel@sydney.edu.au.
Notifying women about dense breasts in screenings increased anxiety and confusion, without improving their sense of being informed. Women sought guidance from general practitioners, potentially increasing consultation burdens.
Area of Science:
- Radiology and Imaging
- Public Health
- Patient Communication
Background:
- Population-based breast screening programs aim for early detection.
- Breast density is an important factor influencing mammographic interpretation and breast cancer risk.
- Current guidelines vary on notifying women about their dense breasts.
Purpose of the Study:
- To evaluate the psychosocial impact of informing women about their mammographically dense breasts.
- To assess changes in health service use intentions following breast density notification.
- To compare effects of written versus video-based information delivery.
Main Methods:
- A multisite, parallel-arm randomized controlled trial was conducted.
- Participants included women aged 40+ undergoing screening with dense breasts (BI-RADS C-D).
- Three groups were compared: standard care, notification with written information, and notification with online video information.
Main Results:
- Women notified of dense breasts reported significantly higher anxiety and confusion.
- Notification increased intentions to consult general practitioners regarding screening results and supplemental screening advice.
- Most women did not intend to pursue supplemental screening; notification did not increase feelings of being informed.
Conclusions:
- Notifying women of dense breasts can lead to adverse psychosocial outcomes, including anxiety and confusion.
- Women desire guidance from their general practitioners, potentially increasing healthcare consultation burden.
- Current notification strategies may not adequately empower women for informed breast health decisions.
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