A new California state law that will take effect April 1 will require facilities that perform mammography to notify women if they are found to have dense breast tissue based on their mammogram reading.
The law also mandates that women be told dense breast tissue can make it harder to evaluate the results of a mammogram and may be associated with an increased risk of breast cancer. The law further stipulates that information about breast density be given to patients to discuss with their doctors, and that women be informed that a range of screening options are available.
“We believe this notification will be a good thing for patients, because it will help raise awareness and serve as the basis for important conversations between women and their doctors,” said Vivian Lim, MD, who specializes in breast imaging with Scripps Clinic. “The earlier we can diagnose and treat breast cancer, the better the outcomes for the patient.”
Dense breast tissue has less fat than glandular and connective tissue. Its presence is the primary reason a mammogram fails to detect cancer, according to the National Cancer Institute. Some research estimates that about 40 percent of women who get a mammogram have dense breast tissue. A recent national survey by Harris Interactive revealed that 95 percent of women don’t know if they have dense breast tissue.
Scripps Cancer Care recommends that healthy women with no family history of breast cancer continue with annual mammography starting at age 40, which is consistent with American Cancer Society guidelines. Dr. Lim reminds patients that the presence of dense breast tissue doesn’t mean they have breast cancer, but rather that additional screening may be helpful for a more detailed evaluation.
There are no global guidelines for imaging dense breasts. Scripps recommends that patients who are identified as having dense breasts consult with their physicians for an individualized discussion about possible additional screening. A number of imaging options are available for dense breast tissue, such as breast ultrasound and breast magnetic resonance imaging, or MRI.
While the new law will offer the benefits of patient education, there are also areas of caution and concern expressed by the American College of Radiology, which are shared by Scripps Health. For example, there is no California state or federal mandate for insurers to cover the cost of additional imaging options, which could lead to an unfortunate disparity between women who can afford to pay for additional exams and those who cannot. Also, for some women, receiving information about breast density may lead to undue anxiety about their risk, or worry that mammography may have missed a breast cancer.
California will become the fifth state with a breast density notification law, according to State Sen. Joe Simitian (D-Palo Alto), who authored Senate Bill 1538. Others states that have passed similar legislation include Connecticut, Texas, Virginia and New York.
Scripps Cancer Care is a comprehensive cancer program that has earned network accreditation from the American College of Surgeons’ Commission on Cancer. Scripps provides comprehensive care at its five hospital campuses and its various outpatient facilities. With more than 300 affiliated physicians, Scripps Cancer Care seeks to provide the best possible treatment and cutting-edge research trials for patients by coordinating medical expertise in the areas of clinical cancer care, community outreach and clinical, translational and basic research.
Learn more about Scripps Health, a nonprofit integrated health system in San Diego, Calif.