Regina J. Hooley MD, Presenter: Consultant, Guerbet

Reni Simov Butler MD, Abstract Co-Author: Nothing to Disclose

Cary P. Gross MD, Abstract Co-Author: Nothing to Disclose

Susan Heidi Busch, Abstract Co-Author: Nothing to Disclose

Liane Elizabeth Philpotts MD, Abstract Co-Author: Consultant, Hologic, Inc.

Connecticut law 09-41 requires radiologists to inform patients with mammographically dense breast tissue that they may benefit from the addition of whole breast ultrasound (WBUS). The purpose of this study is to determine patient awareness of breast density and compliance with supplemental WBUS.

During the period from 1/17/13 to 4/3/13, 236 patients were asked to complete a 12 item self-administered survey assessing knowledge about breast density and WBUS. Breast cancer risk was determined by medical record review. All women had a prior mammogram demonstrating heterogeneous or extremely dense breast tissue. A total of 221/236 patients had analyzable data.

Of the 221 patients, the average age was 52.1 years (median 50 years, range 21-90 years). Breast cancer risk was as follows: very strong, 5% (11/221); intermediate, 10% (23/221); weak or unknown, 85% (187/221). 94% (207/221) were aware of their breast density, with 90% (199/221) informed by their physician and 65% (143/221) receiving WBUS because their doctor ordered the exam. History of prior WBUS was seen in 68% (151/221) and 63% (95/151) received yearly WBUS. The majority of women (91%, 201/221) reported WBUS was important in finding mammographically occult cancer, while 45% (99/221) reported increased anxiety due to breast density awareness and 89% (197/221) reported choosing WBUS despite an increased risk of additional testing. Of 45 women who did not have WBUS, 33% (15/45) reported never discussing breast density with their doctors and 16% (7/45) stated they were not familiar with WBUS. Compared to average risk women, women with elevated risk were more likely to know their breast density (33/34 vs 174/187), more likely to have had a prior WBUS (29/34 vs 140/187) and more amenable to additional testing (32/34 vs 165/187), although this was not statistically significant (p>0.05).

Since implementation of CT 09-41, 90% of women surveyed with dense breast tissue discuss breast density with their physicians and 89% of women report choosing WBUS despite a risk of false positive results. Less than 50% of patients with dense breasts report increased anxiety due to breast density awareness.

Many women are aware of breast density and the limitations of mammography. Women with dense breasts are amenable to supplemental WBUS despite the chance of requiring additional testing or biopsy.

Hooley, R, Butler, R, Gross, C, Busch, S, Philpotts, L, What Do Women Think? Knowledge and Opinions of Women Regarding Breast Density Legislation and Supplemental Whole Breast Ultrasound.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044236.html Accessed August 28, 2025