Psychosocial Impact of Breast Density Notification Through Breast Cancer Screening: A Qualitative Interview Study

Health Expectations

Emma Grundtvig Gram, Claire Hudson, Nehmat Houssami, Kirsten McCaffery, Jennifer Isautier, Brooke Nickel

ABSTRACT

Introduction

Breast density notification is now implemented in the United States and parts of Australia and Canada despite limited understanding of how it impacts women and their psychosocial health. This study explored the psychosocial impact of receiving a notification of dense breasts through a population-based breast cancer screening programme.

Methods

We interviewed 19 Australian women who indicated being anxious in a survey. This survey was part of the first randomised controlled trial aiming to quantify the psychosocial impact of breast density notifications. Semi-structured interviews were conducted over the phone and analysed thematically to provide nuance and perspectives on the psychosocial impact.

Results

The women were 42–78 years old and had diverse ethnic and educational backgrounds. Women generally perceived breast density notifications as valuable for making health decisions, citing female empowerment and the value of information in health. Women described experiences of immediate panic and worry as well as changes to their perceived individual risk of breast cancer. The breast density notification challenged women's previous perceptions of risk of breast cancer, leaving them to reinterpret their need for medical assistance. Women thus described an increased general awareness about breast cancer, which increased their likelihood of performing self-exams and attending breast screenings.

Discussion

While empowerment and increased vigilance in health might present positive strides for women's health, the derivative worry highlights the paradoxical value of health awareness and risk communication. This tension is important to consider in future notification practices and decisions on whether to implement breast density notification.