Australian Women’s Responses to Breast Density Information: A Content Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Analysis
3. Results
3.1. Anxiety
3.2. Responses to Breast Density Notification
3.3. Interest in Supplemental Screening
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic or Response | No. of Participants n (%) |
---|---|
Age | |
40–49 | 23 (29.5) |
50–59 | 23 (29.5) |
60–69 | 21 (27) |
70–75 | 11 (14) |
Marital Status | |
Single | 19 (24.4) |
Married/living with a partner | 41 (52.6) |
Divorce/separated/widowed | 18 (23) |
Aboriginal and/or Torres Strait Islander origin | 2 (2.6) |
Birth Place | |
Australia | 54 (69.2) |
New Zealand, UK, or USA | 16 (20.5) |
Other | 8 (10.3) |
Years since moving to Australia (if born overseas) ** | |
<10 | 3 (3.8) |
10–29 | 2 (2.6) |
>30 | 17 (21.8) |
State of residence | |
New South Wales | 41 (52.6) |
Queensland | 37 (47.4) |
Rurality | |
Urban | 47 (60.2) |
Regional | 30 (38.5) |
Remote | 1 (1.3) |
Highest educational qualification | |
University Degree | 37 (47.4) |
Diploma or Certificate | 27 (34.6) |
Higher School Certificate or equivalent | 8 (10.3) |
School Certificate or intermediate or equivalent | 6 (7.7) |
Employment Status ** | |
Full time | 5 (6.4) |
Part time | 36 (46.2) |
Retired | 16 (20.5) |
Student or other | 20 (25.6) |
WHO-5 Well-Being Index Score (Mean (SD))† | 66.6 (17) |
General self-rate health | |
Excellent, very good, good | 68 (87.2) |
Fair or poor | 10 (12.8) |
Family history of breast cancer | |
Yes | 15 (19.2) |
No | 63 (80.8) |
Worry about developing breast cancer | |
Not worried at all | 21 (26.9) |
Worry a little | 50 (64.1) |
Quite worried | 6 (7.7) |
Very worried | 1 (5.1) |
Breast screening rounds attended | |
None | 12 (15.4) |
Once | 16 (20.5) |
Twice | 6 (7.7) |
Three times | 6 (7.7) |
Four or more times | 38 (48.7) |
Time since last screening (if screened) | |
Within the last 2–3 years | 54 (69.2) |
3 years ago, or more | 12 (15.4) |
Screening services used (if screened) | |
BreastScreen (publicly funded screening program) | 53 (67.9) |
Private screening service | 13 (16.7) |
Been previously told or notified of BD | |
Yes | 9 (11.5) |
No | 69 (88.5) |
Theme Description | Example | Frequency (%) |
---|---|---|
1. Psychological impacts | ‘Getting cancer scares me’ | 23 (29.5) |
1a. Anxious, worried, or concerned | ‘I worry about everything, and I am anxious when it comes to my health as I know I don’t look after myself very well’ | 8 (10.3) |
1b. Increases the risk/possibility of breast cancer | ‘It may increase my chances of getting breast cancer’ | 15 (19.2) |
2. Better informed | ‘I’m now far better informed as a result of this educational session and discussion’ | 21 (26.9) |
2a. Aware of possibility of breast cancer/improve breast health | ‘I would be more aware of the possibility of breast cancer and their options’ | 7 (9.0) |
2b. Reduce risk of breast cancer | ‘Would want to know exactly what steps I need to take to ensure my health and safety’ | 3 (3.8) |
2c. More vigilant | ‘I have already been told this and it did not cause anxiety. Now that I know what it actually means it will just make me more vigilant.’ | 6 (7.7) |
3. Would not worry/not a big deal | ‘I don’t worry about things at the best of times’ | 12 (15.4) |
4. Increased risk due to other risk factors for breast cancer | ‘As I’m aware it’s a risk factor for Breast cancer’ | 10 (12.8) |
4a. Family history | ‘Due to my background and family history of breast cancer’ | 4 (5.1) |
4b. Increase with age | ‘…a higher risk to cancer but knowing it is usually an age issue I would not be highly’ | 1 (1.3) |
5. Mask cancer/harder to detect | ‘It could potentially make it harder to detect cancer’ | 9 (11.5) |
6. Regular screening/further testing | ‘While I can have more thorough screening it is something that I can do little about’ | 6 (7.7) |
7. False positives | ‘I know now that the breast density mammogram test could be also false positive’ | 3 (3.8) |
8. Talk to/discuss with doctors | ‘Would need to discuss this more with my Dr to find out more’ | 2 (2.6) |
9. Miscellaneous/cannot be coded | 6 (7.7) |
Theme | Example | Frequency (%) |
---|---|---|
1. Talk to the doctor/follow doctor’s advice | ‘I would get the advice of my doctor and information first’ | 30 (38.5) |
2. Additional screening—supplemental (ultrasound, MRI), i.e., beyond mammography) | ‘If recommended, have further testing e.g., MRI or ultrasound’ | 18 (23) |
3. Educate oneself—do more research/find out more information | ‘I’d research and look for support groups, contact people who’d been through breast cancer and get more information.’ | 16 (20.5) |
4. Nothing different, i.e., continue regular screening | ‘Nothing more than I do now’ | 15 (19.2) |
5. More frequent mammograms, i.e., every year | ‘Have yearly mammograms’ | 12 (15.4) |
6. Do regular self-checks and examine breasts | ‘Be more judicious with self-examination’ | 8 (10.3) |
7. Not sure what I would do | ‘Not sure’ | 2 (2.5) |
Theme | Example | Frequency (%) |
---|---|---|
1.Wish to be informed/knowledge about their body | ‘To find out more, to know and to take charge of what is best for my body under current medical advice’ | 49 (62.9) |
1a. Want to know the situation, for reassurance | ‘I’d feel more reassured if I had as many tests available as possible’ | 7 (9) |
1b. Want to be informed to rule out cancer | ‘To ensure that cancer was not present’ | 12 (15.4) |
1c. Precaution | ‘To ensure that I had the best available screening opportunities to avoid getting breast cancer’ | 11 (14.1) |
1d. Peace of mind | ‘For my own mental thoughts’ | 5 (6.4) |
2. Dependent on breast screening results | ‘I would have an MRI if I had a lump shown in the scan’ | 9 (11.5) |
2a. If they had symptoms | ‘Depends if felt I had other symptoms’ | 5 (6.4) |
3. Harms | ‘It would depend on my doctor’s recommendation and other risk factors (or lack thereof) to balance up whether supplemental imaging would be more beneficial or not. Need to consider false positives and over diagnosis, which are more likely with supplemental imaging. At this point I don’t believe I am at high risk of breast cancer, so one risk factor (breast density) may not be enough to do supplemental, but if I had further risk factors or my doctor recommended, then I would do the supplemental.’ | 7 (9) |
3a. Risk of overdiagnosis | ‘I do not like the idea of over diagnosis’ | 5 (6.4) |
3b. False positives | ‘The risk of false positives really concerns me—especially in relation to unnecessary treatment’ | 3 (3.8) |
4. Not an issue/not concerned or worried | ‘Because it would be just one factor and at the moment it is not an issue for me’ | 6 (7.7) |
5. Out-of-pocket costs | ‘Concern about potential financial costs’ | 4 (5.1) |
6. Age dependent | ‘The older I get yes, but younger no’ | 3 (3.8) |
7. Miscellaneous/cannot be code | 4 (5.1) |
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Share and Cite
Pandya, T.; Liu, Z.; Dolan, H.; Hersch, J.; Brennan, M.; Houssami, N.; Nickel, B. Australian Women’s Responses to Breast Density Information: A Content Analysis. Int. J. Environ. Res. Public Health 2023, 20, 1596. https://doi.org/10.3390/ijerph20021596
Pandya T, Liu Z, Dolan H, Hersch J, Brennan M, Houssami N, Nickel B. Australian Women’s Responses to Breast Density Information: A Content Analysis. International Journal of Environmental Research and Public Health. 2023; 20(2):1596. https://doi.org/10.3390/ijerph20021596
Chicago/Turabian StylePandya, Tanvi, Zixuan Liu, Hankiz Dolan, Jolyn Hersch, Meagan Brennan, Nehmat Houssami, and Brooke Nickel. 2023. "Australian Women’s Responses to Breast Density Information: A Content Analysis" International Journal of Environmental Research and Public Health 20, no. 2: 1596. https://doi.org/10.3390/ijerph20021596