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Dense Breast Tissue Notifications Confusing Mammogram Patients

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The language used to notify women about dense breast tissue on mammograms is confusing more than helping patients, a study published in The Journal of the American Medical Association confirms.

Nancy Kressin, co-author on the research and a professor at the Boston University Shool of Medicine says that around 40% of women who undergo mammograms are found to have dense breast tissue. Dense breast tissue, which is an increase in connective and fibrous tissues, means a higher risk for breast cancer. The presence of dense breast tissue also lowers the chances of tumors being seen on a mammogram. Women who get mammograms should then be notified if they have dense breast tissue, so they can take extra precautions and be more careful with their breast exams.

The researchers found, however, that notification letters sent in 23 states contained language that was difficult to understand. Most of the letters would require a college degree to properly understand the terms. For example, the notices sent in New Jersey and Connecticut were deemed to be at post-graduate language levels, much higher than the recommended seventh- or eighth-grade readability.

Only 12% of American adults have good health literacy, as stated by the National Assessment of Adult Literacy. Nancy Cappello, who founded the nonprofit organization Are You Dense? as a means to educate the public on dense breast tissue, says that the notification letters vary from state to state.

Kressin states,

For many women, these notifications are not going to be easy to read and might even be alarming. We’ve talked to some women who received these letters, and their reaction was ‘Oh my God, I have cancer.’

The content of the letters were widely varied, with some  recommending that the patient undergo additional tests, some alerting the patients to cancer risks, some advising the patients to consult their doctors. The one thing the notifications had in common was the lack of uniformity.

The study authors are concerned with how these notifications might affect women with low reading skills. Since these letters are meant to start a dialogue between patients and their doctors, it is hoped that this research helps propel the discussion on dense breast tissue, and its impact on breast cancer overall.

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