Factors Influencing Patient Confidence in Screening Mammography

Background: We aimed to assess factors associated with patients' confidence in the ability of screening mammography to detect breast cancer. Methods: Data were analyzed from a cross-sectional, prospective survey conducted in 2017 of women without a breast cancer history who were undergoing screening mammography at our institution. Results: In total, 390 women completed the survey questions relevant to this study. Most respondents were 46 years or older (89.7%), White (87.6%), and college-educated (66.1%). Approximately 80% of respondents reported having confidence in the ability of screening mammography to detect breast cancer. Factors significantly associated with lower confidence in screening mammography were higher education (P=.01) and dense breast tissue (P<.001). Age (P=.12), race (P=.64), family history of breast cancer (P=.17), prior abnormal mammogram (P=.07), and mammogram frequency (P=.42) were nonsignificant. Women with a college education or higher were less likely to report confidence in routine mammography than women with less education (odds ratio [OR]= 0.43; 95% CI, 0.20-0.84; P=.02). Compared with women who reported their breast tissue as not dense, women who were aware they had increased breast density (OR=0.16; 95%CI, 0.04-0.49; P=.004) or were unaware whether they had increased breast density (OR=0.17; 95% CI, 0.04-0.51; P=.005) reported less confidence in screeningmammography. Discussion: Most respondents were confident in the ability of screening mammography to detect breast cancer. Confidence was inversely associated with education level and self-reported increased breast density. Conclusions: These findings highlight the importance of continued patient education about the effectiveness of screening mammography for patients with dense breast tissue.