Perceived risk and adherence to breast cancer screening guidelines among women with a familial history of breast cancer: A review of the literature

Abstract Introduction In Uganda, Breast cancer is the most common cancer in females globally. The majority of the patients present with advanced-stage disease at diagnoses and experience high mortality. This underscores the importance of early detection approaches based on awareness of risk factors and self-perceived risks, and symptoms of the disease to promote adoption of risk reduction behaviors and prompt health-seeking respectively. This study assessed the self-perceived risk of breast cancer, and breast cancer screening behaviours among first-degree female relatives of breast cancer patients in Uganda.Methods This was a cross-sectional study employing quantitative approaches for data collection and analyses. First-degree female relatives of patients attending care at Uganda Cancer Institute were recruited consecutively in the study. A pre-tested coded questionnaire was used to collect data on self-perceived risks, breast cancer risks, and breast cancer screening behaviours. Data were collected between March to October 2019. A modified Poisson regression model was used to evaluate factors associated with self-perceived risk of breast cancer and breast cancer risk awareness.ResultsWe enrolled 296 first-degree female relatives from 197 female breast cancer patients. The median age (IQR) was 33 (26-43) years. A majority (60.1%, 178/296) of the participants had a low self-perceived risk of breast cancer. Breast self-examination (55.7%, 165/296) was the most practiced screening method followed by clinical breast examination (n= 64/296, 21.6%), ultrasound scan of the breast (7.8%, 23/296,), and mammogram (3.7%, 11/296). Women aged 35-44 years had a higher self-perceived risk of breast cancer (adjusted Incident Rate Ratio [aIRR]: 1.75, 95%CI: 1.10-2.80), compared to women aged 18-25 years. ConclusionFirst-degree relatives reported a low self-perceived risk of breast cancer. Breast cancer health education especially targeting younger women should emphasize the increased risk of breast cancer in first-degree relatives of patients with breast cancer. There is a need to increase awareness of breast cancer screening methods and their usefulness in the early detection of breast cancer among all women in Uganda.

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Linking Reminders and Physician Breast Cancer Screening Recommendations: Results From a National Survey

JCO Clinical Cancer Informatics ◽

10.1200/cci.17.00090 ◽

2017 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Elizabeth J. Siembida ◽

Archana Radhakrishnan ◽

Sarah A. Nowak ◽

Andrew M. Parker ◽

Craig Evan Pollack

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Mammography Screening ◽

Primary Care Physicians ◽

Age Groups ◽

National Sample ◽

Average Risk ◽

Screening Guidelines ◽

Practice Characteristics

Purpose Physician reminders have successfully increased rates of mammography. However, considering recent changes to breast cancer screening guidelines that disagree on the optimal age to start and stop mammography screening, we sought to examine the extent to which reminders have been deployed for breast cancer screening targeting younger and older patients. Methods A mailed survey was sent to a national sample of 2,000 primary care physicians between May and September 2016. Physicians were asked whether they received reminders to screen women in various age groups (40 to 44, 45 to 49, and ≥ 75 years), the organizational screening guidelines they trusted most, and whether they recommended routine breast cancer screening to average-risk women in the different age groups. Using regression models, we assessed the association between reminders and physician screening recommendations, controlling for physician and practice characteristics, and evaluated whether the association varied by the guidelines they trusted. Results A total of 871 physicians responded (adjusted response rate, 52.3%). Overall, 28.9% of physicians reported receiving reminders for patient ages 40 to 44 years, 32.5% for patient ages 45 to 49 years, and 16.5% for patient ages ≥ 75 years. Receiving reminders significantly increased the likelihood of physicians recommending mammography screening. In adjusted analyses, 84% (95% CI, 77% to 90%) of physicians who received reminders recommended screening for women ages ≥ 75 versus 65% (95% CI, 62% to 69%) of those who did not receive reminders. The associations between reminders and screening recommendations remained consistent regardless of which guidelines physicians reported trusting. Conclusion Reminders were significantly associated with increases in physician screening recommendations for mammography, underscoring the need for careful implementation in scenarios where guidelines are discordant.

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Expert Board Gives Advice to NCI on Breast Cancer Screening Guidelines

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/85.22.1795 ◽

1993 ◽

Vol 85 (22) ◽

pp. 1795-1795 ◽

Cited By ~ 2

Author(s):

N. Volkers

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Screening Guidelines

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P1-10-07: Comparing Breast Cancer Screening Guidelines: A Stage-Survival-Cost Model in a Public Hospital.

10.1158/0008-5472.sabcs11-p1-10-07 ◽

2011 ◽

Author(s):

DT Friedman ◽

C Raskind-Hood ◽

K Adams ◽

E Becker ◽

I Habtes ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Public Hospital ◽

Cost Model ◽

Screening Guidelines

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Abstract C100: Perceptions of breast cancer screening guidelines and intentions for screening: Qualitative commonalities of and differences between Black and White women age 50-75

10.1158/1538-7755.disp19-c100 ◽

2020 ◽

Author(s):

Maggie Britton ◽

Ashley J. Housten ◽

Diana S. Hoover ◽

Lorna H. McNeill ◽

Robert J. Volk

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

White Women ◽

Screening Guidelines ◽

Black And White

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The Effect of California’s Breast Density Notification Legislation on Breast Cancer Screening

Journal of Primary Care & Community Health ◽

10.1177/2150131916674889 ◽

2016 ◽

Vol 8 (2) ◽

pp. 55-62 ◽

Cited By ~ 13

Author(s):

Stephanie Lynn Chau ◽

Amy Alabaster ◽

Karin Luikart ◽

Leslie Manace Brenman ◽

Laurel A. Habel

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Breast Density ◽

Screening Mammography ◽

Median Income ◽

Cancer History ◽

Screening Guidelines ◽

Younger Women ◽

Dense Breasts

Purpose: Half of US states mandate women be notified if they have dense breasts on their mammogram, yet guidelines and data on supplemental screening modalities are limited. Breast density (BD) refers to the extent that breast tissue appears radiographically dense on mammograms. High BD reduces the sensitivity of screening mammography and increases breast cancer risk. The aim of this study was to determine the potential impact of California’s 2013 BD notification legislation on breast cancer screening patterns. Methods: We conducted a cohort study of women aged 40 to 74 years who were members of a large Northern California integrated health plan (approximately 3.9 million members) in 2011-2015. We calculated pre- and post-legislation rates of screening mammography and magnetic resonance imaging (MRI). We also examined whether women with dense breasts (defined as BI-RADS density c or d) had higher MRI rates than women with nondense breasts (defined as BI-RADS density a or b). Results: After adjustment for race/ethnicity, age, body mass index, medical facility, neighborhood median income, and cancer history, there was a relative 6.6% decrease (relative risk [RR] 0.934, confidence interval [CI] 0.92-0.95) in the rate of screening mammography, largely driven by a decrease among women <50 years. While infrequent, there was a relative 16% increase (RR 1.16, CI 1.07-1.25) in the rate of screening MRI, with the greatest increase among the youngest women. In the postlegislation period, women with extremely dense breasts (BI-RADS d) had 2.77 times (CI 1.93-3.95) the odds of a MRI within 9 months of a screening mammogram compared with women with nondense breasts (BI-RADS b). Conclusions: In this setting, MRI rates increased in the postlegislation period. In addition, women with higher BD were more likely to have supplementary MRI. The decrease in mammography rates seen primarily among younger women may have been due to changes in national screening guidelines.

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