{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T18:53:26Z","timestamp":1769108006960,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T00:00:00Z","timestamp":1600041600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R21CA209442"],"award-info":[{"award-number":["R21CA209442"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2020,12,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>State\u2010specific breast density notification legislation requires that women undergoing mammography be informed about breast density, with variation among states. Because mammography facilities are among the main points of contact for women undergoing mammography, research is needed to understand how facilities communicate information on breast density, cancer risk, and supplemental screening to women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional, 50\u2010item, mailed survey of 156 American College of Radiology\u2013certified mammography facilities in North Carolina was conducted in 2017 via the Tailored Design Method. Breast density notification practices, supplemental screening services, and patient educational materials were compared by supplemental screening availability via <jats:italic>t<\/jats:italic> tests and chi\u2010square tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All responding facilities (n\u00a0=\u00a094; 60.3% response rate) notified women of their breast density in the mammography results letter. Breast cancer risk assessments were performed by 36.2% of the facilities, with risk information communicated in the final radiology report for the referring provider to discuss with the woman (79.4%) or in the results letter (58.8%). Supplemental breast cancer screening was offered by 63.8% of the facilities, with use based on multiple factors, including recommendations from the referring physician (63.3%) or reading radiologist (63.3%), breast density (48.3%), other risk factors (48.3%), and patient request (40.0%). Although 75.0% of the facilities offered breast density educational materials, only 36.6% offered educational materials on supplemental screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a state with a breast density notification law, mammography facilities communicate breast density, cancer risk, and supplemental screening information to women through various approaches. When supplemental screening is offered, facilities use multiple decision\u2010making criteria rather than breast density alone.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33198","type":"journal-article","created":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T06:49:20Z","timestamp":1601189360000},"page":"5230-5238","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Understanding the response of mammography facilities to breast density notification"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8356-9267","authenticated-orcid":false,"given":"Louise M.","family":"Henderson","sequence":"first","affiliation":[{"name":"Radiology Department University of North Carolina  Chapel Hill North Carolina"},{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina  Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary W.","family":"Marsh","sequence":"additional","affiliation":[{"name":"Radiology Department University of North Carolina  Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Earnhardt","sequence":"additional","affiliation":[{"name":"Radiology Department University of North Carolina  Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Pritchard","sequence":"additional","affiliation":[{"name":"Radiology Department University of North Carolina  Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thad S.","family":"Benefield","sequence":"additional","affiliation":[{"name":"Radiology Department University of North Carolina  Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert P.","family":"Agans","sequence":"additional","affiliation":[{"name":"Biostatistics Department University of North Carolina  Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Radiology Department University of North Carolina  Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,9,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju255"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062790"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-148-5-200803040-00004"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03540010035027"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djh269"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-3-200302040-00008"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052911"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.5919"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1712"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2017.6539"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2018.7429"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.13131217"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2013.09.007"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.14.13558"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.7326\/M15-1789"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781394260645"},{"key":"e_1_2_8_18_1","unstructured":"American College of Radiology.The gold standard in imaging accreditation. 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