A Randomized Feasibility Study of Patient Navigation for Women Identified with Dense Breast Tissue on Breast Cancer Screening Mammography
Women found to have dense breast tissue on a screening mammogram are at 2-6 times increased risk of developing breast cancer. In November 2013, legislation was passed in Pennsylvania to require that women with dense breast tissue be notified of the finding, along with their screening mammogram results. However, women frequently report uncertainty and questions about supplemental screening, such as automated breast ultrasound or magnetic resonance imaging, often recommended by radiologists and breast health experts. In addition, women report that the language of the required notification is unclear and does not aid them in making a decision regarding supplemental breast cancer screening. In addition, supplemental screening, is not available at all mammography facilities. Thus, women with dense breast tissue may experience barriers, such as lack of knowledge about dense breast tissue and breast cancer risk, as well as fear of, transportation to or payment for supplemental screening.
Patient navigation is an evidence-based, patient-centered approach to overcome barriers to breast cancer screening, diagnosis, and care. These barriers are often more prevalent among patients who are medically underserved. However, patient navigation has not been tested in the context of women with dense breast tissue.
The AWARE study is a randomized study to test the feasibility of patient navigation for women with dense breast tissue. Participants in the usual care arm will receive usual clinic-based education and small media while participants in the intervention arm will receive usual care and a 12-week telephone-based navigation. The primary outcomes of the study include patient knowledge about dense breast tissue and breast cancer risk, as well as actual receipt of supplemental screening.
The study is being conducted by investigators with the Department of Public Health Sciences, Radiology, Family and Community Medicine, in conjunction with the Penn State Breast Center and the Penn State Cancer Institute. The study was begun in June 2018 and seeks to enroll at least 60 women. Eligibility requirements include being between 40 and 74 years of age, having never been diagnosed with breast cancer, and having had a screening mammogram within the past 3 months with negative or benign results for breast cancer and having a report of heterogeneously dense or extremely dense breast tissue.
For more information, contact Sol Rodriquez-Colon srodriguez-colon@psu.edu or 717-531-5190.