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Bhattacharjee A, Walsh D, Dasari P, Hodson LJ, Edwards S, White SJ, Turnbull D, Ingman WV. Factors Associated with Increased Knowledge about Breast Density in South Australian Women Undergoing Breast Cancer Screening. Cancers (Basel) 2024; 16:893. [PMID: 38473255 DOI: 10.3390/cancers16050893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Background: There is growing awareness of breast density in women attending breast cancer screening; however, it is unclear whether this awareness is associated with increased knowledge. This study aims to evaluate breast density knowledge among Australian women attending breast cancer screening. Method: This cross-sectional study was conducted on women undergoing breast cancer screening at The Queen Elizabeth Hospital Breast/Endocrine outpatient department. Participants were provided with a questionnaire to assess knowledge, awareness, and desire to know their own breast density. Result: Of the 350 women who participated, 61% were familiar with 'breast density' and 57% had 'some knowledge'. Prior breast density notification (OR = 4.99, 95% CI = 2.76, 9.03; p = 0.004), awareness (OR = 4.05, 95% CI = 2.57, 6.39; p = 0.004), younger age (OR = 0.97, 95% CI = 0.96, 0.99; p = 0.02), and English as the language spoken at home (OR = 3.29, 95% CI = 1.23, 8.77; p = 0.02) were independent predictors of 'some knowledge' of breast density. A significant proportion of participants (82%) expressed desire to ascertain their individual breast density. Conclusions: While knowledge of breast density in this Australian cohort is generally quite low, we have identified factors associated with increased knowledge. Further research is required to determine optimal interventions to increase breast density knowledge.
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Affiliation(s)
- Avisak Bhattacharjee
- Discipline of Surgical Specialties, Adelaide Medical School, The Queen Elizabeth Hospital, University of Adelaide, Woodville South, SA 5011, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, SA 5006, Australia
| | - David Walsh
- Discipline of Surgical Specialties, Adelaide Medical School, The Queen Elizabeth Hospital, University of Adelaide, Woodville South, SA 5011, Australia
| | - Pallave Dasari
- Discipline of Surgical Specialties, Adelaide Medical School, The Queen Elizabeth Hospital, University of Adelaide, Woodville South, SA 5011, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, SA 5006, Australia
| | - Leigh J Hodson
- Discipline of Surgical Specialties, Adelaide Medical School, The Queen Elizabeth Hospital, University of Adelaide, Woodville South, SA 5011, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, SA 5006, Australia
| | - Suzanne Edwards
- School of Public Health, University of Adelaide, Adelaide, SA 5005, Australia
| | - Sarah J White
- Centre for Social Impact, University of New South Wales, Sydney, NSW 2052, Australia
| | - Deborah Turnbull
- School of Psychology, University of Adelaide, Adelaide, SA 5005, Australia
| | - Wendy V Ingman
- Discipline of Surgical Specialties, Adelaide Medical School, The Queen Elizabeth Hospital, University of Adelaide, Woodville South, SA 5011, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, SA 5006, Australia
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Best R, Wilkinson LS, Oliver-Williams C, Tolani F, Yates J. Should we share breast density information during breast cancer screening in the United Kingdom? an integrative review. Br J Radiol 2023; 96:20230122. [PMID: 37751169 PMCID: PMC10646652 DOI: 10.1259/bjr.20230122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/25/2023] [Accepted: 08/24/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE Dense breasts are an established risk factor for breast cancer and also reduce the sensitivity of mammograms. There is increasing public concern around breast density in the UK, with calls for this information to be shared at breast cancer screening. METHODS We searched the PubMed database, Cochrane Library and grey literature, using broad search terms in October 2022. Two reviewers extracted data and assessed the risk of bias of each included study. The results were narratively synthesised by five research questions: desire for information, communication formats, psychological impact, knowledge impact and behaviour change. RESULTS We identified 19 studies: three Randomised Controlled Trials (RCTs), three cohort studies, nine cross-sectional studies, one qualitative interview study, one mixed methods study and two 2021 systematic reviews. Nine studies were based in the United States of America (USA), five in Australia, two in the UK and one in Croatia. One systematic review included 14 USA studies, and the other 27 USA studies, 1 Australian and 1 Canadian. The overall GRADE evidence quality rating for each research question was very low to low.Generally, participants wanted to receive breast density information. Conversations with healthcare professionals were more valued and effective than letters. Breast density awareness after notification varied greatly between studies.Breast density information either did not impact frequency of mammography screening or increased the intentions of participants to return for routine screening as well as intention to access, and uptake of, supplementary screening. People from ethnic minority groups or of lower socioeconomic status (SES) had greater confusion following notification, and, along with those without healthcare insurance, were less likely to access supplementary screening. CONCLUSION Breast density specific research in the UK, including different communities, is needed before the UK considers sharing breast density information at screening. There are also practical considerations around implementation and recording, which need to be addressed. ADVANCES IN KNOWLEDGE Currently, sharing breast density information at breast cancer screening in the UK may not be beneficial to participants and could widen inequalities. UK specific research is needed, and measurement, communication and future testing implications need to be carefully considered.
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Affiliation(s)
- Rebecca Best
- NHS England Screening Quality Assurance Service, Health Education England, England, United Kingdom
| | | | - Clare Oliver-Williams
- NHS England Screening Quality Assurance Service, Health Education England, England, United Kingdom
| | - Foyeke Tolani
- Public Health Department, Bedford Borough Council, Bedford, United Kingdom
| | - Jan Yates
- NHS England Screening Quality Assurance Service, Health Education England, England, United Kingdom
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Gauci SL, Couto JG, Mizzi D. Survey of knowledge and awareness of breast density amongst Maltese Women undergoing mammography screening. Radiography (Lond) 2023; 29:911-917. [PMID: 37473492 DOI: 10.1016/j.radi.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/12/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION The ratio of breast glandular tissue to fatty tissue is known as breast density. This study assessed the knowledge and awareness of breast density of Maltese women undergoing mammography screening at the National Screening Unit. Increased breast density knowledge may lead to an increase in supplementary imaging attendance. In Europe, there are very limited studies assessing the knowledge and awareness of breast density, providing a solid rationale for this study to be done locally. METHODS Women aged 50 to 69 who were eligible for breast cancer screening at the National Screening Unit were given a validated closed-ended questionnaire as part of a quantitative, prospective, cross-sectional, and descriptive study. The questionnaire was designed to achieve the aims of the study. Using IBM-SPSS (v28) software, the data was analysed using the Friedman and Kruskal Wallis tests. RESULTS A total of 127 surveys were gathered, with a maximum margin of error of 8.66% based on a 95% confidence range. Breast density and the risks associated with it were not well known or understood (average scores ranging from 2.80 to 3.34 out of 5), but supplemental screening was more widely known (3.65). Participants' knowledge and awareness were correlated with their age, profession, and degree of education. Leaflets (40%) and medical experts (40%) were respondents' favourite sources of information. CONCLUSION The population under study lacks knowledge and awareness of breast density and the risks it entails. It's important to provide women more details about breast density. With this information, women will be empowered to seek the finest care. IMPLICATIONS FOR PRACTICE Although some socio-demographic parameters were linked to women's knowledge and awareness, it is advised that more research be done using a bigger sample size through interviews and other studies. Moreover, more information regarding breast density must be provided to women undergoing breast cancer screening in Malta to increase their knowledge and awareness.
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Affiliation(s)
- S L Gauci
- Department of Radiography, Faculty of Health Sciences, University of Malta, Msida, Malta.
| | - J G Couto
- Department of Radiography, Faculty of Health Sciences, University of Malta, Msida, Malta.
| | - D Mizzi
- Department of Radiography, Faculty of Health Sciences, University of Malta, Msida, Malta.
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Mansour S, Soliman S, Kansakar A, Marey A, Hunold C, Hanafy MM. Strengths and challenges of the artificial intelligence in the assessment of dense breasts. BJR Open 2022; 4:20220018. [PMID: 38525169 PMCID: PMC10958665 DOI: 10.1259/bjro.20220018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/27/2022] [Accepted: 07/20/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives High breast density is a risk factor for breast cancer and overlapping of glandular tissue can mask lesions thus lowering mammographic sensitivity. Also, dense breasts are more vulnerable to increase recall rate and false-positive results. New generations of artificial intelligence (AI) have been introduced to the realm of mammography. We aimed to assess the strengths and challenges of adopting artificial intelligence in reading mammograms of dense breasts. Methods This study included 6600 mammograms of dense patterns "c" and "d" and presented 4061 breast abnormalities. All the patients were subjected to full-field digital mammography, breast ultrasound, and their mammographic images were scanned by AI software (Lunit INSIGHT MMG). Results Diagnostic indices of the sono-mammography: a sensitivity of 98.71%, a specificity of 88.04%, a positive-predictive value of 80.16%, a negative-predictive value of 99.29%, and a diagnostic accuracy of 91.5%. AI-aided mammograms presented sensitivity of 88.29%, a specificity of 96.34%, a positive-predictive value of 92.2%, a negative-predictive value of 94.4%, and a diagnostic accuracy of 94.5% in its ability to read dense mammograms. Conclusion Dense breasts scanned with AI showed a notable reduction of mammographic misdiagnosis. Knowledge of such software challenges would enhance its application as a decision support tool to mammography in the diagnosis of cancer. Advances in knowledge Dense breast is challenging for radiologists and renders low sensitivity mammogram. Mammogram scanned by AI could be used to overcome such limitation, enhance the discrimination between benign and malignant breast abnormalities and the early detection of breast cancer.
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Affiliation(s)
| | - Somia Soliman
- Pathology, Kasr ElAiny Hospital, Cairo University, Cairo, Egypt
| | - Abisha Kansakar
- Radiology, Kasr ElAiny Hospital, Cairo University, Cairo, Egypt
| | - Ahmed Marey
- FUJIFILM Medical Imaging and IT Solutions MEA, Dubai, United Arab Emirates
| | - Christiane Hunold
- FUJIFILM Medical Imaging and IT Solutions MEA, Dubai, United Arab Emirates
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Brédart A, De Pauw A, Anota A, Tüchler A, Dick J, Müller A, Kop JL, Rhiem K, Schmutzler R, Devilee P, Stoppa-Lyonnet D, Dolbeault S. Information needs on breast cancer genetic and non-genetic risk factors in relatives of women with a BRCA1/2 or PALB2 pathogenic variant. Breast 2021; 60:38-44. [PMID: 34455229 PMCID: PMC8403756 DOI: 10.1016/j.breast.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/29/2021] [Accepted: 08/21/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Comprehensive breast cancer (BC) risk models integrating effects of genetic (GRF) and non-genetic risk factors (NGRF) may refine BC prevention recommendations. We explored the perceived information received on BC risk factors, and related characteristics, in female relatives of women with a BRCA1/2 or PALB2 pathogenic variant, undergoing BC risk assessment using the CanRisk© prediction tool. METHODS Of 200 consecutive cancer-free women approached after the initial genetic consultation, 161 (80.5%) filled in questionnaires on their perception of information received and wished further information on BC risk factors (e.g., being a carrier of a moderate risk altered gene, personal genetic profile, lifestyles). Multilevel multivariate linear models were performed accounting for the clinician who met the counselee and exploring the effect of counselees' socio-demographic, familial and psychological characteristics on the perceived extent of information received. RESULTS Perceived no/little information received and wish for further information were more frequent for NGRF (>50%) than for GRF, especially high-risk genes (<20%). Perceived amount of information received and desire for further information were inversely correlated (p=<0.0001). Higher education level related to lower perceived levels of information received on GRF. Younger counselees' age (β = 0.13, p = 0.02) and less frequent engagement coping (e.g., inclination to solicit information) (β = 0.24, p = 0.02) related to lower perceived information received about NGRF. Other assessed counselees' features were not found to be associated to GRF and NGRF information perception. CONCLUSIONS Awareness of counselees' perceived lack of information on BC risk factors indicates a need to enhance evidence-based information on BC NGRF especially.
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Affiliation(s)
- Anne Brédart
- Institut Curie, Supportive Care Department, Psycho-oncology Unit, PSL University, 26 rue d'Ulm, Paris, 75005 Paris Cedex 05, France; University of Paris, 71 Avenue Edouard Vaillant, Boulogne-Billancourt, 92774, France.
| | - Antoine De Pauw
- Institut Curie, Cancer Genetic Clinic, PSL University, 26 rue d'Ulm, 75005 Paris Cedex 05, France
| | - Amélie Anota
- Centre Léon Bérard, Department of Clinical Research and Innovation& Human and Social Sciences Department, 28 rue Laennec, Lyon; French National Platform Quality of Life and Cancer, Lyon, 69373, France
| | - Anja Tüchler
- Center for Familial Breast and Ovarian and Cancer for Integrated Oncology (CIO), Kerpener Str. 62 50937 Cologne, University Hospital of Cologne, Cologne, Germany
| | - Julia Dick
- Center for Familial Breast and Ovarian and Cancer for Integrated Oncology (CIO), Kerpener Str. 62 50937 Cologne, University Hospital of Cologne, Cologne, Germany
| | - Anita Müller
- Institut Curie, Supportive Care Department, Psycho-oncology Unit, PSL University, 26 rue d'Ulm, Paris, 75005 Paris Cedex 05, France; VCR, École de Psychologues Praticiens de l'Institut Catholique de Paris, 23 Rue du Montparnasse, 75006, Paris, France
| | - Jean-Luc Kop
- Université de Lorraine, 2LPN, 3 Place Godefroy de Bouillon, Nancy, 54 015 Nancy Cedex, France
| | - Kerstin Rhiem
- Center for Familial Breast and Ovarian and Cancer for Integrated Oncology (CIO), Kerpener Str. 62 50937 Cologne, University Hospital of Cologne, Cologne, Germany
| | - Rita Schmutzler
- Center for Familial Breast and Ovarian and Cancer for Integrated Oncology (CIO), Kerpener Str. 62 50937 Cologne, University Hospital of Cologne, Cologne, Germany
| | - Peter Devilee
- Leiden University Medical Centre, Department of Human Genetics, Department of Pathology, S4-P, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
| | - Dominique Stoppa-Lyonnet
- Institut Curie, Cancer Genetic Clinic, PSL University, 26 rue d'Ulm, 75005 Paris Cedex 05, France
| | - Sylvie Dolbeault
- Institut Curie, Supportive Care Department, Psycho-oncology Unit, PSL University, 26 rue d'Ulm, Paris, 75005 Paris Cedex 05, France; CESP, University Paris-Sud, UVSQ, INSERM, University Paris-Saclay, 16 Avenue Paul Vaillant-Couturier, 94807, Villejuif Cedex, France
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