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Study: Dense breast notifications are informative but hard to read and understand

Some states offer women dense breast notifications that are meant to explain that dense breasts are risk factors for breast cancer and can hide cancer on mammograms, and to identify appropriate supplemental screening options. But recent research found that this information is often not easy to read or understand, which questions the usefulness of the documents. (6/7/16)

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Contents

At a glance                  Questions for your doctor
Findings               In-depth                
Clinical trials Limitations
Guidelines Resources


STUDY AT A GLANCE

What is this study about?

In almost half of the states in the U.S., some or all women receive a dense breast notification (DBN) with their . But do women understand what these notifications are trying to say?

Why is this study important?

Information that is difficult to read or understand may fail its purpose to inform women about dense breasts, whether they may have them, and important alternatives to .

Study findings: 

  1. The majority of DBNs explain that breasts with dense tissue can hide cancer on mammograms, and that they are linked to an increased risk of breast cancer. The notifications also identify other options for screening dense breasts. But while these DBNs include all of this information, researchers found that the documents are hard to understand, and the majority of them were written at a reading level that is too high.

What does this mean for me?

This research indicates that dense breast notifications, while informative, are difficult to read and understand. Women who have any questions about their DBN or screening results should never hesitate to contact their health care provider for clarification, because it is important that all patients understand information that is presented to them.

Posted 6/7/16

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References

Kressin NR, Gunn CM, Battaglia TA. “Content, Readability, and Understandability of Dense Breast Notifications by State.” JAMA. April 26, 2016, Volume 315, Number 16, 1786-788.

Disclosure

FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.

Expert Guidelines

Laws and guidelines address screening of women with dense breasts. Laws regarding breast density notification vary by state. The National Comprehensive Cancer Network (NCCN) has guidelines on breast screening. The panel notes that dense breasts are associated with an increased risk for breast cancer, and they recommend the following: 

  • Women with dense breasts identified by a mammogram should be counseled on the risks and benefits of additional breast screening. 
  • Digital mammograms benefit young women and women with dense breasts.
  • (3D ) can increase cancer detection and lower the chances of additional call backs.
  • may improve the detection of cancers in women with dense breasts but it can also increase the number of callbacks and biopsies of benign (noncancerous) tissue. 

Updated: 02/06/2022

Questions To Ask Your Doctor

  • What does having dense breasts mean for me?
  • How can I lower my breast cancer risk?
  • I have a dense breast notification and carry a mutation in a gene that increases cancer risk. How does this affect my screening options?
  • What other screening methods can I use?
  • I live in a state that does not provide a dense breast notification with my screening result. How do I know if I have dense breasts?
  • Who do I contact if I do not understand what my Dense Breast Notification says?

Open Clinical Trials

The following are breast cancer screening or prevention studies enrolling people at high risk for breast cancer:

Additional risk-management clinical trials for people at high risk for breast cancer may be found here.

Updated: 05/28/2025

Who covered this study?

The New York Times

Notifications about dense breasts can be hard to interpret This article rates 4.5 out of 5 stars

Boston University

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The same article was also covered by Medical Xpress

Study finds readability of dense breast notifications poor This article rates 4.0 out of 5 stars

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