Kathleen Ai-Lan Khong MD, Presenter: Nothing to Disclose

Jonathan Blake Hargreaves MD, Abstract Co-Author: Nothing to Disclose

Shadi Aminololama-Shakeri MD, Abstract Co-Author: Nothing to Disclose

Karen K. Lindfors MD, Abstract Co-Author: Research Grant, Hologic, Inc

A state breast density law, effective April 1, 2013, requires mammography facilities in this state to inform patients if they have dense breasts and to direct them to their primary physicians for questions on breast density and supplemental screening tests. This study investigates primary physician awareness of the law and its impact on outpatient primary care practice and management.

An online survey was distributed to 174 physicians within a large single primary care network system in February 2014, 10 months after a state breast density law took effect. Responses were anonymous. The survey was completed by 77 physicians, 39% from Internal Medicine, 47% from Family Medicine, and 9% from Obstetrics-Gynecology departments. A slight majority (53%) were female. 72% had been practicing for greater than 10 years.

49% of respondent physicians were not aware of the Breast Density legislation prior to the survey. 32% reported noticing a change in patient levels of concern about breast density in 2013 compared to prior years. Only 5% of primary physicians were “completely comfortable” answering patient questions about breast density, while 25% were “mostly comfortable”. 51% reported themselves as “somewhat comfortable” discussing such questions and 11% were “not comfortable”. 48% of respondents reported that they “rarely” answer questions about breast density. Twenty percent of physicians reported they had ordered supplementary screening tests for women with dense breasts who had no other breast cancer risk factors. Of those that ordered additional testing, 44% ordered Breast MRI, 22% ordered whole breast ultrasound, 11% ordered tomosynthesis, and 22% ordered other unspecified testing.

Nearly half of physicians from one primary care network were not aware of the state's breast density notification law, 10 months after it went into effect. Most were not completely comfortable discussing breast density with patients. Enactment of breast density notification laws without the provision of adequate primary physician education and resources is unlikely to significantly impact patient care.

15 states have enacted breast density laws. Physician awareness of the laws and knowledge about breast density are crucial in deciding whether renewal or adoption in additional states is warranted.

Khong, K, Hargreaves, J, Aminololama-Shakeri, S, Lindfors, K, Impact of State Breast Density Legislation on Primary Care Physicians.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14008249.html