Thank you for taking part in our survey on breast density. We really value your time and feedback!
IF YOU'VE HAD A MAMMOGRAM SINCE FEBRUARY 1, 2014 ­­ WE'D LOVE TO HEAR FROM YOU!

A new law (Act 86) now requires that women receiving a mammogram be given information as to her level of breast density. We would like to know what you learned about your breast density after your recent mammogram. We are also making a list of best methods for telling women about their findings.

1. Did your mammogram results tell you about your level of breast density?

2. At the time of your most recent mammogram: (Check all that apply)

3. What breast density category do you have?

4. Have any of the people below talked about your breast density results with you? (Check all that apply)

5. If you were told you have dense breasts, has anyone talked to you about added tests?

6. Did you get any other information (e.g. brochure, flyer, web links, fact sheet) on breast density in addition to your mammography report? (Check all that apply)

7. How much does the following statement reflect how you feel?

  Strongly Agree Agree Unsure Disagree Strongly Disagree
I have an understanding of breast density and its risks.

8. Is there anything else you would like to share about the way you were told about breast density?

WE ARE ASKING FOR COPIES OF MAMMOGRAPHY REPORTS THAT TALK ABOUT BREAST DENSITY. All you need to do is cross out your name and send it to us one of three ways:

Email: Michelle@PABreastCancer.org
FAX: attn: Michelle, 717-769-2131
Mail: PBCC | 2397 Quentin Rd., Suite B | Lebanon, PA 17042

If you got any other information on breast density when you had your mammogram, we would be grateful if you send a copy of that as well.

THANK YOU!


9. If you would like updates on breast density information and follow-up on this survey, please let us know how to reach you:

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