Personalized videos may improve knowledge of breast density after mammography

Women who view personalized videos about breast density after screening mammography have better knowledge about the issue than those who receive informational letters only, a new study found.

Researchers performed a randomized controlled trial of women ages 40 to 74 years who had no history of breast cancer and who had normal results or a benign finding on screening mammography to determine whether short, personalized informational videos improved knowledge of breast density. Women who were eligible for the study from May 1 to Oct. 6, 2017, were sent a letter requesting their participation in addition to the letter with their mammogram results, which included legislatively mandated language on personal breast density.

All of the women in the study completed a survey at baseline that collected data on their risk factors for breast cancer, knowledge of personal breast cancer risk, and knowledge of personal breast density. Women in the intervention group then were able to watch a three- to five-minute online video that included personalized information on breast density and breast cancer risk. The study's primary outcomes, assessed in a survey two weeks after completion of the baseline survey, were knowledge of personal breast density and knowledge of personal breast cancer risk. Results were published online Aug. 8 by the Journal of General Internal Medicine.

Two hundred thirty-five women in the intervention group and 224 women in the control group completed both the baseline and outcome assessment survey. Median patient age was 57 years, and most patients were white, had graduated from college, and had private insurance. Overall, 66.8% and 67.9% of women in the intervention and control groups, respectively, could identify their personal breast cancer risk correctly at baseline; at outcome assessment, the percentage of women in the intervention group who could do so increased to 74.0% while no difference was seen in the control group (odds ratio for change, 1.42; P=0.01). In addition, 39.2% of the intervention group and 36.2% of the control group could identify their breast density at baseline. At outcome assessment, the percentage increased to 77.5% for the intervention group and did not change in the control group (odds ratio for change, 5.34; P<0.001). Women in the intervention group were also more likely than those in the control group to report that they had discussed their mammography results with their primary care clinician (35.5% vs. 25.5%; P=0.05).

The current study had a brief follow-up period and included only English-speaking women who were able to access online videos and surveys, among other limitations, the authors said. However, they concluded that a brief personalized video after mammography can help improve knowledge of personal breast density and breast cancer risk and that including information on breast density in a letter with mammography results did not appear to be associated with improved knowledge. The authors called for longer-term studies to help understand how educational tools like videos affect patients' knowledge and use of screening over extended periods.

An article in the July/August ACP Internist discussed ways to incorporate breast density and risk into screening protocols in clinical practice.