title: Impact of the California breast density law on primary care physicians.
abstract: OBJECTIVE
  To investigate primary physician awareness of the California Breast Density Notification Law and its impact on primary care practice.
  
  
  METHODS
  An online survey was distributed to 174 physicians within a single primary care network system 10 months after California's breast density notification law took effect. The survey assessed physicians' awareness of the law, perceived changes in patient levels of concern about breast density, and physician comfort levels in handling breast density management issues.
  
  
  RESULTS
  The survey was completed by 77 physicians (45%). Roughly half of those surveyed (49%) reported no knowledge of the breast density notification legislation. Only 32% of respondents noted an increase in patient levels of concern about breast density compared to prior years. The majority were only "somewhat comfortable" (55%) or "not comfortable" (12%) with breast density questions, and almost one-third (32%) had referred patients to a breast health clinic for these discussions. A total of 75% of those surveyed would be interested in more specific education on the subject.
  
  
  CONCLUSIONS
  Awareness among primary care clinicians of the California Breast Density Notification Law is low, and many do not feel comfortable answering breast density-related patient questions. Breast imagers and institutions may need to devote additional time and resources to primary physician education in order for density notification laws to have significant impact on patient care.
authors.affiliation: Department of Radiology, University of California, Davis, School of Medicine, Sacramento, California. Electronic address: kathleen.khong@ucdmc.ucdavis.edu.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Khong
authors.affiliation: Department of Radiology, University of California, Davis, School of Medicine, Sacramento, California.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hargreaves
authors.affiliation: Department of Radiology, University of California, Davis, School of Medicine, Sacramento, California.
authors.forename: Shadi
authors.initials: S
authors.lastname: Aminololama-Shakeri
authors.affiliation: Department of Radiology, University of California, Davis, School of Medicine, Sacramento, California.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Lindfors
mesh_terms: D000328:Adult; D002140:California; D002983:Clinical Competence / Q000331:legislation & jurisprudence / Q000592:standards*; D005260:Female; D033161:Government Regulation; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008327:Mammography; D008875:Middle Aged; D010358:Patient Participation / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D058007:Physicians, Primary Care / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*
keywords: Breast density; legislation; mammography; screening