{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:39:59Z","timestamp":1777916399234,"version":"3.51.4"},"reference-count":50,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2018,5,1]],"date-time":"2018-05-01T00:00:00Z","timestamp":1525132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Dense breasts on mammography independently increases breast cancer risk and decreases mammography sensitivity. Thirty-two states have adopted notification laws to raise awareness among women with dense breasts about supplemental screening. Little is known about these policies' impact on clinical practice among primary care providers (PCPs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic toggle=\"yes\">Methods:<\/jats:italic>\n                      <\/jats:bold>\n                      This study explores PCP attitudes, knowledge, and the impact of the Massachusetts dense breast notification legislation on clinical practice after its enactment in 2015. An anonymous, online survey at two urban safety-net hospitals was administered in 2015\u20132016. Practicing MDs and nurse practitioners in primary care were invited to participate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      All 145 PCPs in general internal medicine at the two sites were e-mailed a survey link and 80 (55%) were completed. While 64 of 80 PCPs surveyed (80%) had some familiarity with the legislation, none identified the 8 required components of notifications contained in the Massachusetts legislation. Forty-nine percent (39\/80) did not feel prepared to respond to patient questions about dense breasts. Forty-one percent (33\/80) correctly identified that no current guidelines recommend the use of supplemental screening tests solely based on breast density and 85% (68\/80) indicated interest in further training. Female and less experienced providers were more likely to be in favor of the legislation (49% vs. 11% by gender; 76% &lt;5 years vs. 9%&gt; 20 years). Women practitioners (55%) who were more likely than men (17%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.01) to agree with the policy changed their discussions of mammography results with patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>PCPs feel underprepared to counsel women about breast density identified on mammography and its implications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2017.6539","type":"journal-article","created":{"date-parts":[[2018,1,17]],"date-time":"2018-01-17T11:49:06Z","timestamp":1516189746000},"page":"615-622","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":37,"title":["Primary Care Provider Experience with Breast Density Legislation in Massachusetts"],"prefix":"10.1177","volume":"27","author":[{"given":"Christine M.","family":"Gunn","sequence":"first","affiliation":[{"name":"Boston Medical Center"},{"name":"Boston University School of Public Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy R.","family":"Kressin","sequence":"additional","affiliation":[{"name":"Boston Medical Center"},{"name":"Boston University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Cooper","sequence":"additional","affiliation":[{"name":"Boston Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cinthya","family":"Marturano","sequence":"additional","affiliation":[{"name":"Tufts Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen M.","family":"Freund","sequence":"additional","affiliation":[{"name":"Tufts Medical Center"},{"name":"Institute for Clinical Research and Health Policy Studies"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy A.","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Boston Medical Center"},{"name":"Boston University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,5,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/92.13.1081"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/M14-1465"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062790"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-06-0034"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju078"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-148-5-200803040-00004"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.3040"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.6326"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.18.2151"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/91.23.2020"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-013-2830-5"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2013.09.018"},{"key":"e_1_3_3_14_2","unstructured":"Are you Dense Advocacy Inc. 2016. D.E.N.S.E. State Efforts. Available at: http:\/\/areyoudenseadvocacy.org Accessed November15 2016."},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2013.09.006"},{"key":"e_1_3_3_16_2","unstructured":"An Act Relative to Breast Cancer Early Detection. House No 3733. United States of America The Commonwealth of Massachusetts 2014."},{"key":"e_1_3_3_17_2","unstructured":"Dense Breast Info Inc. 2017. Legislation and Regulations\u2014What is Required? 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