The impact of breast density notification on rescreening rates within a population-based mammographic screening program

Background High participation in mammographic screening is essential for its effectiveness to detect breast cancers early and thereby, improve breast cancer outcomes. Breast density is a strong predictor of breast cancer risk and significantly reduces the sensitivity of mammography to detect the disease. There are increasing mandates for routine breast density notification within mammographic screening programs. It is unknown if breast density notification impacts the likelihood of women returning to screening when next due (i.e. rescreening rates). This study investigates the association between breast density notification and rescreening rates using individual-level data from BreastScreen Western Australia (WA), a population-based mammographic screening program. Methods We examined 981,705 screening events from 311,656 women aged 40+ who attended BreastScreen WA between 2008 and 2017. Mixed effect logistic regression was used to investigate the association between rescreening and breast density notification status. Results Results were stratified by age (younger, targeted, older) and screening round (first, second, third+). Targeted women screening for the first time were more likely to return to screening if notified as having dense breasts (Percentunadjusted notified vs. not-notified: 57.8% vs. 56.1%; Padjusted = 0.016). Younger women were less likely to rescreen if notified, regardless of screening round (all P < 0.001). There was no association between notification and rescreening in older women (all P > 0.72). Conclusions Breast density notification does not deter women in the targeted age range from rescreening but could potentially deter younger women from rescreening. These results suggest that all breast density notification messaging should include information regarding the importance of regular mammographic screening to manage breast cancer risk, particularly for younger women. These results will directly inform BreastScreen programs in Australia as well as other population-based screening providers outside Australia who notify women about breast density or are considering implementing breast density notification.

Women’s conceptual knowledge about breast cancer screening and overdiagnosis in Norway: a cross-sectional study

ObjectiveTo investigate conceptual knowledge about mammographic screening among Norwegian women.DesignWe administered a cross-sectional, web-based survey. We used multiple-choice questions and a grading rubric published by a research group from Australia.SettingOur Norwegian-language survey was open from April to June 2020 and targeted women aged 45–74 years.Participants2033 women completed our questionnaire. We excluded 13 women outside the target age range and 128 women with incomplete data. Responses from 1892 women were included in the final study sample.Primary and secondary outcome measuresThe questionnaire focused on women’s knowledge about the breast cancer mortality reduction, false positive results and overdiagnosis associated with mammographic screening. The primary outcome was the mean number of marks assigned in each of the three themes and overall. There were three potential marks for questions about breast cancer mortality, one for false positives and six for overdiagnosis.ResultsMost women (91.7%) correctly reported that screened women are less likely to die of breast cancer than non-screened women. 39.7% of women reported having heard of a ‘false positive screening result’ and 86.2% identified the term’s definition; 51.3% of women had heard of ‘overdiagnosis’ and 14.8% identified the term’s definition. The mean score was 2.59 of 3 for questions about breast cancer mortality benefit and 0.93 of 1 for the question about false positive screening results. It was 2.23 of 6 for questions about overdiagnosis.ConclusionsMost participants correctly answered questions about the breast cancer mortality benefit and false positive results associated with screening. The proportion of correct responses to questions about overdiagnosis was modest, indicating that conceptual knowledge about overdiagnosis was lower. Qualitative studies that can obtain in-depth information about women’s understanding of overdiagnosis may help improve Norwegian-language information about this challenging topic.

Microarray analysis of ductal carcinoma in situ samples obtained by puncture from surgical resection specimens

Objective The incidence of ductal carcinoma in situ (DCIS) is increasing due to more widespread mammographic screening. DCIS, the earliest form of breast cancer, is non-invasive at the time of detection. If DCIS tissues are left undetected or untreated, it can spread to the surrounding breast tissue. Thus, surgical resection is the standard treatment. Understanding the mechanism underlying the non-invasive property of DCIS could lead to more appropriate medical treatments, including nonsurgical options. Data description We conducted a microarray-based genome-wide transcriptome analysis using DCIS specimens obtained by puncture from surgical specimens immediately after surgery.

Impact of breast cancer awareness health campaigns on knowledge of female educationalists of Islamabad and Rawalpindi; an interventional study

Introduction: Breast carcinoma is the leading cause of cancer in women worldwide. WHO statistics show 1.2 million new cases every year. Pakistan reports nearly 40,000 lives from Breast Cancer annually. Objective: To evaluate existing awareness levels regarding breast cancer among female educationalists in twin cities and to counsel the participants about diagnostic tools such as mammographic-screening and breast self-examination Methodology: The study design was an interventional community trial and was conducted on female teachers aged 30-60 years. Data was collected by a questionnaire, given before and after the interactive session to evaluate its impacts. SPSS Version 23 was used for data entry analysis. Descriptive statistics were used to calculate the quantitative and qualitative variables. McNemar’s test was applied for this. P values less than 0.05 were considered significant. Results: Total number of participants was 106 women with a median age of 43.3 years (range of age 31-54 years). Before intervening, 67 (63.2%) participants had no knowledge of mammographic-screening and 15 (14.2%) participants didn’t know the definitive way of diagnosing it. 2 After intervention, mammogram was selected to be the definitive way of diagnosing breast cancer by 91 (85.8%) participants. 91(85.8%) participants would encourage close family and friends to get screened. 104 (98.1%) of women had become familiar with technique of self-examination, as compared to 63 (59.4%) before. Conclusion: Misconceptions about risk factors, screening methods and diagnostic procedures were identified and elucidated. This encouraged participants to start performing regular self-exams and get mammograms.