Increasing Awareness of the Role of Breast Density as an Independent Risk Factor for Breast Cancer: A Pilot Study

Abstract

Breast cancer is the second leading cause of cancer deaths among women in the United States (U.S.), affecting one in every eight women (American Cancer Society, 2017). Dense breast tissue can mask or hide breast cancer, delaying identification of breast cancer and early treatment (Lei, Yang, Zhang, Wang & Yang, 2013). Breast density (BD) is an independent risk factor for breast cancer (Falcon, Williams, Weinfurtner, & Drukteinis, 2017). A woman’s mammogram determines BD. Current breast-screening guidelines vary from leading U.S. preventative organizations, making prevention education difficult for providers and patients to understand (Nguyen-Pham et al., 2014; Weaver & Gjesfjeld, 2014). Notification of BD legislation has increased awareness about BD. Gunn et al. (2018) found that BD notification letters are often written at a higher reading level. These issues cause barriers to understanding BD and confusion regarding how BD factors into screening recommendations as an independent risk factor for breast cancer. The purpose of this practice improvement project (PIP) was to increase awareness of dense breast tissue as an independent risk factor for breast cancer, assess current understanding of BD among rural women with known dense breast tissue, and to increase awareness of BD among healthcare professionals in rural healthcare. Thirteen women with known dense breast tissue participated in the PIP. A questionnaire was used to assess rural women’s knowledge and awareness of dense breast tissue. All participants (N=13) received personalized education on BD and risk for breast cancer. Almost all women acknowledged that having dense breasts does make it more difficult to see breast cancer on a mammogram (n=12; 92.3%), however only 46.2% (n= 6) recognize BD as a risk factor for breast cancer. Almost all women (n=12; 92.3%) did not feel knowledgeable about their dense breast tissue, however more than half (n=10; 76.9%) were comfortable about making decisions regarding the type of screening to have with their dense breasts. Results were aggregated and disseminated to providers. Providers had an increased awareness of dense breast tissue and the risk for breast cancer. In addition, BD notifications were revised to reflect a seventh-grade reading level.