Randomized Trial of Personalized Breast Density and Breast Cancer Risk Notification
Despite widespread implementation of mammographic breast density (MBD) notification laws, the impact of these laws on knowledge of MBD and knowledge of breast cancer risk is limited by the lack of tools to promote informed decision-making in practice.
To develop and evaluate whether brief, personalized informational videos following a normal mammogram in addition to a legislatively required letter about MBD result can improve knowledge of MBD and breast cancer risk compared to standard care (i.e., legislatively required letter about MBD included with the mammogram result).
Prospective randomized controlled trial of English-speaking women, age 40–74 years, without prior history of breast cancer, receiving a screening mammogram with a normal or benign finding (intervention group n = 235, control group n = 224). Intervention: brief (3–5 min) video, personalized to a woman’s MBD result and breast cancer risk.
Primary outcomes were a woman’s knowledge of her MBD and risk of breast cancer. Secondary outcomes included whether a woman reported that she discussed the results of her mammogram with her primary care provider (PCP).
Relative to women in the control arm, women in the intervention arm had greater improvement in their knowledge of both their personal MBD (intervention pre/post 39.2%/ 77.5%; control pre/post 36.2%/ 37.5%; odds ratio (OR) 5.34 for change for intervention vs. control, 95% confidence interval (CI) 3.87–7.36; p < 0.001) and risk of breast cancer (intervention pre/post: 66.8%/74.0%; control pre/post 67.9%/ 65.2%; OR 1.42, 95% confidence interval (CI) 1.09–1.84; p = 0.01). Women in the intervention group were more likely than those in the control group to report discussing the results of their mammogram with their PCP (p = 0.05).
Brief, personalized videos following mammography can improve knowledge of MBD and personal risk of breast cancer compared to a legislatively mandated informational letter.
KEY WORDSmammography breast density breast cancer risk patient education
We would like to acknowledge Debora Kim, Center for Population Health Patient Engagement at Brigham and Women’s Hospital, for her help filming the Vidscrip. This study was supported by a grant from the Controlled Risk Insurance Company, Ltd. (CRICO)/ Risk Management Foundation of the Harvard Medical Institutions; the funder did not have a role in the design or conduct of the study.
Compliance with Ethical Standards
The protocol was reviewed and approved by the Institutional Review Board (IRB) of Partners Healthcare.
Conflict of Interest
The authors declare that they do not have a conflict of interest.
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