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

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.