Sociodemographic Factors and Ethnic Disparities in Breast Density Awareness and Anxiety Among Women With Dense Breasts.

Abstract

Objective: To determine sociodemographic and clinical factors associated with breast density awareness and anxiety in women with dense breasts.

Methods: This cross-sectional retrospective study, from a breast cancer screening prospective case collection registry (NCT03257839), analyzed patient-reported awareness of their breast density and related anxiety with sociodemographic variables. Asymptomatic women aged ≥40 with heterogeneously or extremely dense breasts completed a prescreening questionnaire at 9 Mammography Quality Standards Act-certified centers spanning 8 states with and without breast density notification laws (BDNLs).

Results: Among 6873 women (mean age 54.6 ± 9.3 years) with 99.4% (6833/6873) questionnaire completion, 71.7% (4930/6873) of participants were aware of their breast density. Self-reported Hispanic/Latina women comprised 15.4% (1055/6873), of whom 75.5% (796/1055) had a state BDNL. Fewer Hispanic/Latina women with a BDNL in effect were aware of density than non-Hispanic/Latina women (50.7% [403/795] vs 83.9% [2416/2880], P <.001). In multivariable analyses, the adjusted odds ratio (AOR) of breast density awareness was higher in women with some college education (AOR 2.70 [95% CI, 2.36-3.08]), BDNL in effect (AOR 2.09 [95% CI, 1.86-2.34]), self-reported ethnicity of not Hispanic or Latina (AOR 1.68 [95% CI, 1.45-1.96]), and aged 70 to 79 years (AOR 1.73 [95% CI, 1.35-2.22]), 60 to 69 years (AOR 1.45 [95% CI, 1.25-1.69]), or 50 to 59 years (AOR 1.30 [95% CI, 1.15-1.48]) when compared with 40 to 49 years. Women with awareness were more likely to be anxious (AOR 1.98 [95% CI, 1.76-2.24]).

Conclusions: Despite overall density awareness in women with dense breasts and BDNL implementation, health care providers should address disparities of awareness and target discussions with women under 50, individuals with a Hispanic/Latina background, and those less educated.