# The Impact of Breast Density Notification on Anxiety in South Australian Women Undergoing Breast Cancer Screening

## TL;DR

This study found that telling women their breast density during cancer screening does not increase anxiety, and most reactions are positive or neutral.

## Contribution

The study is the first to assess anxiety impacts of breast density notification in South Australian women using the STAI tool.

## Key findings

- State anxiety scores were not significantly different between women with dense and nondense breasts.
- Most women's reactions to breast density notification were positive or neutral, with only 17% being negative.
- Severe trait anxiety was observed in 23% and 20% of women in the dense and nondense groups, respectively.

## Abstract

Purpose: The purpose was to investigate the impact of breast density notification on anxiety using the State and Trait Anxiety Inventory (STAI) tool in South Australian women undergoing breast cancer screening.

Methods: A survey-based cross-sectional mixed method study was conducted in women attending breast cancer screening at the Queen Elizabeth Hospital Breast/Endocrine outpatient department (n = 100). The women had participated in a previous study assessing their general knowledge of breast density and had indicated they wanted to know their own breast density. Breast density was assessed using Volpara software, and the participants were notified by letter. The STAI tool was administered with an additional question asking how participants felt after being told their breast density. State and trait anxiety levels were compared between those receiving notification of dense breasts and those notified of nondense breasts.

Results: State anxiety scores were not different between women notified they had dense breasts (n = 34, mean state anxiety ± SD; 36.65 ± 13.03) and those who had nondense breasts (n = 66, 35.17 ± 13.60, p = 0.51). Severe trait anxiety was observed in 8 of 34 (23%) and 13 of 66 (20%) women in the dense and nondense groups, respectively, and there were no significant differences. Qualitative analysis of 122 coded responses revealed the majority of reactions to breast density notification were positive or neutral, with 17% being negative.

Conclusion: Notification of dense breasts was not associated with elevated anxiety when compared to the notification of nondense breasts. Breast density notification approaches need to be considerate of the significant proportion of women with severe underlying anxiety.