Abstract
Purpose
Nationally legislated dense breast notification (DBN) informs women of their breast density (BD) and the impact of BD on breast cancer risk and detection, but consequences for screening participation are unclear. We evaluated the association of DBN in New York State (NYS) with subsequent screening mammography in a largely Hispanic/Latina cohort.
Methods
Women aged 40–60 were surveyed in their preferred language (33% English, 67% Spanish) during screening mammography from 2016 to 2018. We used clinical BD classification from mammography records from 2013 (NYS DBN enactment) through enrollment (baseline) to create a 6-category variable capturing prior and new DBN receipt (sent only after clinically dense mammograms). We used this variable to compare the number of subsequent mammograms (0, 1, ≥ 2) from 10 to 30 months after baseline using ordinal logistic regression.
Results
In a sample of 728 women (78% foreign-born, 72% Hispanic, 46% high school education or less), first-time screeners and women who received DBN for the first time after prior non-dense mammograms had significantly fewer screening mammograms within 30 months of baseline (Odds Ratios range: 0.33 (95% Confidence Interval (CI) 0.12–0.85) to 0.38 (95% CI 0.17–0.82)) compared to women with prior mammography but no DBN. There were no differences in subsequent mammogram frequency between women with multiple DBN and those who never received DBN. Findings were consistent across age, language, health literacy, and education groups.
Conclusion
Women receiving their first DBN after previous non-dense mammograms have lower mammography participation within 2.5 years. DBN has limited influence on screening participation of first-time screeners and those with persistent dense mammograms.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.
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Acknowledgments
We would like to thank the study participants for contributing data and Rossy Sandoval and Melissa Rodriguez for data collection.
Funding
This work was supported by grants from the National Institute on Minority Health and Health Disparities (1R01MD011506).
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PT conceived of the original research question, design of the cohort and oversaw the implementation of the study. CBR and MA contributed to the data acquisition and cleaning, administrative and technical study support, data interpretation, and feedback on manuscript writing. ELA, and PT led and conducted the statistical analysis, writing and reviewing manuscript drafts, tables, interpretation, and manuscript writing. CBR, ELA, MBT, PT, and YW contributed to the analysis plan and interpretation of results. AK, KMS, and ED contributed critical feedback when reviewing the final manuscript draft. All authors read and provided critical feedback on intellectual content during the manuscript process and provided final approval.
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This study was performed in line with the policies of Columbia University’s Institutional Review Board (approval IRBAAAQ6108).
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Lee Argov, E.J., Rodriguez, C.B., Agovino, M. et al. Screening mammography frequency following dense breast notification among a predominantly Hispanic/Latina screening cohort. Cancer Causes Control (2024). https://doi.org/10.1007/s10552-024-01871-7
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DOI: https://doi.org/10.1007/s10552-024-01871-7