"Highlights

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Most patients expressed interest in and comfort with breast cancer risk assessment, with acceptance of AI-based risk estimation derived from mammography compared with survey-based risk models.

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Patients preferred receiving breast cancer risk information from their clinical providers, highlighting the importance of integrating risk assessment into existing care pathways rather than radiology-only workflows.

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Identification of increased breast cancer risk was associated with high patient interest in additional screening, particularly breast MRI and whole breast ultrasound.

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Interest in genetic testing was significantly higher among patients with reported breast cancer risk factors, supporting early risk identification as a potential gateway to appropriate genetic evaluation.

Abstract

Objective

To evaluate patient perspectives on breast cancer, risk assessment, and screening tools.

Methods

This IRB-approved HIPAA-compliant study included an anonymous 12-question survey administered to female patients at 4 medical clinics (2 radiology, 1 internal medicine and 1 gynecology) in Northern California during May–June 2024. Results were compared using Fisher exact tests between groups. A p-value of <0.05 was considered significant.

Results

Surveys were completed by 319 patients at radiology (160), gynecology (80) and internal medicine (79) clinics. On a scale of 1 (not concerned) to 5 (extremely concerned), 34.7% (111/319) reported 4 or 5 out of 5 concern for developing breast cancer. Among respondents not aware of their lifetime risk, 77.2% (85/110) were interested in obtaining a risk assessment. Most respondents (80.5% (257/319)) reported they would be comfortable with breast cancer risk assessment derived from their screening mammogram by AI-based methods, compared to 31.0% (99/319) using personal/family history obtained from a survey. Patients surveyed at gynecology and radiology offices preferred obtaining their risk results from their gynecologist (82.5% (66/80)) (p ≤ 0.001), (57.3% (90/157)) (p = 0.006), and patients surveyed at the internal medicine clinic (63.3% (50/79) (p = 0.081) preferred their PCP. If found to be at increased risk, 90.3% (288/319) of patients reported interest in additional screening tests. Most patients at increased breast cancer risk (72% (111/154)) reported interest in genetic testing, compared with 50% (84/165) of patients not at increased breast cancer risk (p = 0.001).

Conclusion

Patients demonstrated a strong interest in AI-based risk assessment using their screening mammogram, and those at higher risk expressed interest in additional breast cancer screening tools and genetic testing."