Abstract
BACKGROUND: Breast density is an important yet often overlooked factor in breast cancer screening. Limited awareness among women can hinder informed decision-making, especially in regions without standardized breast density notification, such as Saudi Arabia. OBJECTIVE: This study aimed to assess awareness, knowledge, and educational needs related to breast density among women in Saudi Arabia. METHODS: A nationwide, cross-sectional survey was conducted using a structured online questionnaire. Saudi women aged 30 years and older were recruited via convenience sampling through social media platforms and targeted mailing lists. The survey collected demographic data and assessed participants' breast density (BD) awareness, knowledge, perceived risk, and preferred information sources. Data analysis included both descriptive and inferential statistical methods. RESULTS: 1,021 Saudi women (30-75 years old) participated in this study. Only 11.4% of the sample had heard of breast density, and less than half of those (5%) understood its association with breast cancer risk. Women with higher education and previous mammography experience had significantly higher awareness (OR: 5.00, 95% CI: 2.18-11.45; p<0.001 and 1.81, 95% CI: 1.15-2.86; p=0.010, respectively). A vast majority (80%) expressed interest in being informed about their breast density, and more than half (56.3%) are willing to pay for additional imaging if they had dense breast tissue. CONCLUSION: Awareness of breast density among women in Saudi Arabia is remarkably low, likely due to the absence of structured education, lack of provider-patient communication, and no national notification policy. Despite this, women express a clear willingness to receive related information. There is a critical need for targeted education on breast density. National health strategies should prioritize breast density awareness and standardized communication in breast cancer screening programs.