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Randomized Trial of Personalized Breast Density and Breast Cancer Risk Notification

  • Jennifer S. Haas
  • Catherine S. Giess
  • Kimberly A. Harris
  • Julia Ansolabehere
  • Celia P. Kaplan
Original Research

Abstract

Background

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.

Objective

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).

Design/Participants

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.

Main Measures

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).

Key Results

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).

Conclusions

Brief, personalized videos following mammography can improve knowledge of MBD and personal risk of breast cancer compared to a legislatively mandated informational letter.

Trial Registration

Clinicaltrials.gov (NCT02986360)

KEY WORDS

mammography breast density breast cancer risk patient education 

Notes

Acknowledgements

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.

Supplementary material

11606_2018_4622_MOESM1_ESM.docx (17 kb)
ESM1 (DOCX 16 kb)

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Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Jennifer S. Haas
    • 1
  • Catherine S. Giess
    • 2
  • Kimberly A. Harris
    • 1
  • Julia Ansolabehere
    • 1
  • Celia P. Kaplan
    • 3
  1. 1.Division of General Medicine and Primary Care, Department of Medicine Brigham and Women’s HospitalBostonUSA
  2. 2.Department of Radiology, Division of Breast ImagingBrigham and Women’s HospitalBostonUSA
  3. 3.Division of General Internal Medicine, Department of MedicineUniversity of California, San FranciscoSan FranciscoUSA

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