Abstract
Laws mandating that women be informed of mammographic breast density (MBD) with their mammogram results may increase anxiety. We report on changes in self-reported levels of anxiety, worry about developing breast cancer (BC), as well as perceived risk of BC resulting from three MBD notification methods: usual care (mailed notification letter), enhanced care (usual care with MBD educational brochure), or interpersonal care (enhanced care with promotora education), among a Latina population.
A randomized controlled clinical trial of three MBD notifications was performed among Latina women aged 40 to 74 years receiving screening mammography at a federally qualified health center (FQHC). Measures of anxiety, BC worry and perceived lifetime BC risk were assessed using a questionnaire. Anxiety was measured using the State-Trait Anxiety Inventory scale (STAI-S). The question: "How frequently do you worry about getting breast cancer someday" assessed BC worry. perceived lifetime risk of BC was rated between 0% (no chance) to 100% (definitely will get). Additional surveys were completed at two weeks to six months (T1) and one year (T2) after the intervention.
1332 Latina women were randomized between October 2016 and October 2019. At T0, 51.8% had moderate or severe anxiety. BC worry was reported to be sometimes/ often/ almost all the time among 41.3% of participants. 25.4% reported a perceived lifetime risk of developing BC of > 10%, compared with 6.6% with Gail model estimated lifetime risk score of > 10%. There was no significant difference in the proportion of patients who maintained low or had decrease in their levels of anxiety, BC worry or perceived risk from T0 to either T1 or T2 surveys between intervention groups.
This Latina cohort had high levels of anxiety and BC worry which persisted regardless of intervention received. Future work is needed to improve our understanding of factors that could lower anxiety and BC worry and improve BC risk perception in this population.
ClinicalTrials.gov, NCT02910986. Registered on 22/09/2016.