Education About Breast Density Does Not Improve Screening Adherence Among Racial and Ethnic Minority Women

Journal of Women’s Health

Brooke Nickel, Nehmat Houssami

Breast density continues to be a topic of international discussion due to high density being an independent risk factor for breast cancer1 with a masking effect on mammography,2,3 coupled with the high proportion of women in the breast screening population who have dense breasts.4 One of the key drivers for notifying women about their breast density has been to empower them to become informed and more involved in future and additional screening in order to manage their breast cancer risk. The United States Food and Drug Administration’s (FDA) final rule on notifying women attending mammography services of their breast density when they have a mammogram is now enacted.5,6 However, over the last few years, there has been increasing concern that these breast density notification laws may further disadvantage racial and ethnic minority women,7,8 with calls to ensure equitable outcomes. While the FDA rule includes guidance on specific information to include in the patient lay summaries, this information also includes the potential for additional screening for those with dense breasts despite nonconsensus on clear and equitable clinical pathways,9 and it is not clear that the FDA has tested the information with women from different cultural and linguistic groups. Moreover, the FDA has not prepared the notification in languages other than English, leaving it up to the discretion of each individual screening provider or program to do so. Conti…