By Lisa Rapaport

(Reuters Health) – A growing number of U.S. women understand that breast density can impact cancer risk, but a new study suggests this isn’t prompting more patients to discuss the issue with their doctors.

As of 2017, 66% of women were aware that dense breast tissue is associated with an increased risk of cancer, up from about 59% in 2012, researchers report in the Journal of the American College of Radiology.

But less than half of women familiar with this risk discussed breast density with their healthcare providers, and the proportion didn’t change substantially during the five-year study period.

“The discussion was more often initiated by the healthcare provider than the (patient), regardless of whether the (patient) reported having dense breasts,” lead study author Dr. Deborah Rhodes of the Mayo Clinic in Rochester, Minnesota, and colleagues write.

“Among those who reported having dense breasts, the source of this information was most commonly the healthcare provider who ordered the mammogram,” they note.

Roughly half of U.S. women in their 40s and 50s have dense breast tissue, which increases their risk of breast cancer and makes it harder to detect tumors with mammography.

Several states require healthcare providers to send notification letters to women whose mammograms show dense breast tissue. Some states also require that these higher-risk women be advised to get screened with ultrasound or MRI, which can better detect tumors in dense breast tissue.

A new proposal from the U.S. Food and Drug Administration, announced March 28, would require all mammography facilities in the U.S. to include breast density information in letters to patients. The FDA says it is proposing specific language that would explain how breast density can influence the accuracy of mammography.

For the current study, researchers administered an identical breast density survey to women aged 40 to 74 in 2012 and 2017.

In the study, women’s knowledge about breast density appeared higher in states with dense-breast notification laws than in states without these laws on the books.

Over this time, the proportion of women who had heard of breast density who also understood the potential for denser tissue to obscure tumors rose from about 72% to 77%, the study found. This difference was too small to be meaningful, the study team concludes.

However, only about 47% of women with awareness of breast density discussed this topic with a healthcare provider in 2017, compared with 43% five years earlier.

Among women aware of BD, knowledge of the impact on breast cancer risk has increased, but knowledge of the impact on masking has not.

In both 2012 and 2017, white women and more affluent women were more likely to be aware of breast density than Hispanic women or low-income women.

This suggests “the need for continued educational efforts focusing on populations vulnerable to disparities in health care access and outcomes,” the study team notes.

SOURCE: Journal of the American College of Radiology, online November 19, 2019.