{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:01:07Z","timestamp":1790103667457,"version":"4.0.1"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Breast density notification is now implemented in the United States and parts of Australia and Canada despite limited understanding of how it impacts women and their psychosocial health. This study explored the psychosocial impact of receiving a notification of dense breasts through a population\u2010based breast cancer screening programme.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We interviewed 19 Australian women who indicated being anxious in a survey. This survey was part of the first randomised controlled trial aiming to quantify the psychosocial impact of breast density notifications. Semi\u2010structured interviews were conducted over the phone and analysed thematically to provide nuance and perspectives on the psychosocial impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The women were 42\u201378 years old and had diverse ethnic and educational backgrounds. Women generally perceived breast density notifications as valuable for making health decisions, citing female empowerment and the value of information in health. Women described experiences of immediate panic and worry as well as changes to their perceived individual risk of breast cancer. The breast density notification challenged women's previous perceptions of risk of breast cancer, leaving them to reinterpret their need for medical assistance. Women thus described an increased general awareness about breast cancer, which increased their likelihood of performing self\u2010exams and attending breast screenings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>While empowerment and increased vigilance in health might present positive strides for women's health, the derivative worry highlights the paradoxical value of health awareness and risk communication. This tension is important to consider in future notification practices and decisions on whether to implement breast density notification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>This study is based on interviews with 19 women who have lived experience with breast density information. The semi\u2010structured interview guide allowed the women to influence what was considered important and relevant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70539","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T16:40:56Z","timestamp":1773074456000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Psychosocial Impact of Breast Density Notification Through Breast Cancer Screening: A Qualitative Interview Study"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8519-8217","authenticated-orcid":false,"given":"Emma Grundtvig","family":"Gram","sequence":"first","affiliation":[{"name":"Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"},{"name":"Center for General Practice, Department of Public Health University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0954-0722","authenticated-orcid":false,"given":"Claire","family":"Hudson","sequence":"additional","affiliation":[{"name":"Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehmat","family":"Houssami","sequence":"additional","affiliation":[{"name":"Wiser Healthcare, School of Public Health The University of Sydney Sydney New South Wales Australia"},{"name":"The Daffodil Centre, A Joint Venture With Cancer Council NSW The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"McCaffery","sequence":"additional","affiliation":[{"name":"Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"},{"name":"Wiser Healthcare, School of Public Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Isautier","sequence":"additional","affiliation":[{"name":"Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke","family":"Nickel","sequence":"additional","affiliation":[{"name":"Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"},{"name":"Wiser Healthcare, School of Public Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.222129"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12282-018-0857-5"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062790"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-3-200302040-00008"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51216"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju255"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm-2020-111364"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djab016"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2024-083649"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2018.01.017"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13187-020-01778-2"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4709-y"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32002"},{"key":"e_1_2_12_15_1","unstructured":"BreastScreen Australia Clinical Advisory Group.BreastScreen Australia Position Statement on Mammographic (Breast) Density and Screening. November 6 2024. Department of Health Disability and Ageing Australian Government cited September 26 2025 https:\/\/www.health.gov.au\/sites\/default\/files\/2025-05\/breastscreen-australia-position-statement-on-breast-density-and-screening.pdf."},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2018.09.001"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-021-06203-w"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.52117"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta17130"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6334"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2024.103693"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/17482631.2023.2233253"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1017\/9781107295094.005"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11091230"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2022.06.006"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.46743\/2160-3715\/2021.5010"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1037\/13620-004"},{"key":"e_1_2_12_28_1","first-page":"45","article-title":"The Art of Coding and Thematic Exploration in Qualitative Research","volume":"15","author":"Williams M.","year":"2019","journal-title":"International Management Review"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-074256"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/13698575.2019.1652729"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.12866"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022146510386794"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1086\/320004"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/13648470301269"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2014.11.001"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2003.11.012"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.16784"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/13648470600738435"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2021.0343"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2021.06.026"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.52209"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003373"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001877.pub5"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.12745"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2024-222818"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm-2025-113874"}],"container-title":["Health Expectations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.70539","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hex.70539","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.70539","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:40:27Z","timestamp":1777459227000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hex.70539"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":45,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/hex.70539"],"URL":"https:\/\/doi.org\/10.1111\/hex.70539","archive":["Portico"],"relation":{},"ISSN":["1369-6513","1369-7625"],"issn-type":[{"value":"1369-6513","type":"print"},{"value":"1369-7625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]},"assertion":[{"value":"2025-03-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70539"}}