Whitney Palmer

Dense Breast Tissue Legislation Presents Challenges for Practitioners

Published on the Feb. 20, 2012, DiagnosticImaging.com website

By Whitney L.J. Howell

It’s been two years since Connecticut enacted a law requiring providers to tell patients in writing if they have dense breast tissue. Research shows that breast cancer detection is up in the state, but industry leaders and practitioners say complying with the law is often complicated.

The move to include specific breast density information in a letter about mammography results was borne out of one Connecticut patient’s diagnosis with late-stage breast cancer. Doctors missed the malignancy because she had dense breast tissue. Her experience eventually led the state to pass a law, mandating providers inform patients of their breast tissue status. These letters have led to supplemental ultrasound screenings.

Other states are following suit. On Jan. 1, Texas enacted its version of dense breast legislation, known as Henda’s Law, and the American College of Radiology (ACR) anticipates 13 other states will introduce dense breast bills this year. Legislation has also been introduced at the federal level, but it hasn’t yet gained traction. And the potential lack of national continuity could be problematic.

“If a mandate to give patients breast density information happens state-by-state, it will be piecemeal. A national effort would, hopefully, put people all on the same page,” said Barbara Monsees, MD, chair of the ACR’s Breast Imaging Commission. “Differing laws proposed by different states could result in providers having an inconsistent understanding of what they are required to do.”

While the ACR supports patient education and notification about breast cancer risk, the organization cautions that without a standardized method for determining breast density, making categorizations is subjective. Without clear guidelines, different radiologists could rate the breast tissue differently based on the same mammogram. In addition, breast density is only one facet of breast cancer risk — others, such as family history or genetic disposition, play larger roles.

To read the remainder of the story: http://www.diagnosticimaging.com/womens-imaging/content/article/113619/2034076

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