Patient awareness of breast density and interest in supplemental screening tests: comparison of an academic facility and a county hospital.
OBJECTIVE
The aim of this study was to measure women's knowledge of breast density and their attitudes toward supplemental screening tests in the setting of the California Breast Density Notification Law at an academic facility and a county hospital, serving women with higher and lower socioeconomic status, respectively.


METHODS
Institutional review board exemptions were obtained. A survey was administered during screening mammography at two facilities, assessing women's awareness of and interest in knowing their breast density and interest in and willingness to pay for supplemental whole breast ultrasound and contrast-enhanced spectral mammography (CEMG). The results were compared by using Fisher exact tests between groups.


RESULTS
A total of 105 of 130 and 132 of 153 women responded to the survey at the academic and county facilities, respectively. Among respondents at the academic and county facilities, 23% and 5% were aware of their breast density, and 94% and 79% wanted to know their density. A majority were interested in supplemental ultrasonography and CEMG at both sites; however, fewer women had a willingness to pay for the supplemental tests at the county hospital compared with those at the academic facility (22% and 70%, respectively, for ultrasound, P < .0001; 20% and 65%, respectively, for CEMG, P < .0001).


CONCLUSIONS
Both groups of women were interested in knowing their breast density and in supplemental screening tests. However, women at the county hospital were less willing to incur out-of-pocket expenses, suggesting a potential for a disparity in health care access for women of lower socioeconomic status after the enactment of breast density notification legislation.
Department of Radiology, Stanford University School of Medicine, Stanford, California.
Long
L
Trinh
Department of Radiology, Stanford University School of Medicine, Stanford, California.
Debra M
DM
Ikeda
Department of Radiology, Stanford University School of Medicine, Stanford, California.
Kanae K
KK
Miyake
Department of Radiology, Santa Clara Valley Medical Center, San Jose, California. Electronic address: jenntrinhmd@gmail.com.
Jennifer
J
Trinh
Department of Radiology, Santa Clara Valley Medical Center, San Jose, California.
Kevin K
KK
Lee
Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut.
Haatal
H
Dave
Department of Radiology, Santa Clara Valley Medical Center, San Jose, California.
Kei
K
Hanafusa
Department of Radiology, Stanford University School of Medicine, Stanford, California.
Jafi
J
Lipson
D015502:Absorptiometry, Photon / Q000191:economics / Q000706:statistics & numerical data; D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis*; D002140:California / Q000453:epidemiology; D018563:Disease Notification / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D057220:Health Literacy / Q000706:statistics & numerical data*; D006766:Hospitals, County / Q000706:statistics & numerical data*; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D008327:Mammography / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010358:Patient Participation / Q000191:economics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
Breast density notification law; breast cancer; mammography; socioeconomic status; supplement screening tests