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Research Letter |

Content, Readability, and Understandability of Dense Breast Notifications by State

Nancy R. Kressin, PhD1; Christine M. Gunn, PhD2; Tracy A. Battaglia, MD, MPH2
[+] Author Affiliations
1Veterans Affairs Boston Healthcare System, Boston University School of Medicine, Boston, Massachusetts
2Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
JAMA. 2016;315(16):1786-1788. doi:10.1001/jama.2016.1712.
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This study characterizes the content and reading level of text in state-mandated dense breast notifications sent to women in the United States.

Along with their screening mammogram results, women in nearly half of US states also receive notifications of breast density, a result of legislation intended to assist in making personalized decisions about further action. Dense breasts can mask cancer on mammography (masking bias), and are an independent cancer risk factor, but evidence does not yet indicate whether or what supplemental screening is appropriate. Rather, risk stratification is proposed to determine who may benefit from supplemental screening (eg, magnetic resonance imaging for women at high risk).1,2

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Adult Dense Breast Notification (DBN) Literacy Among 19 States

The Flesch-Kinkaid reading level scale has a theoretical lower bound of −3.4 and no upper bound.

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