Mammography images showing, from left to right, BI-RADS breast tissue density scores from 1 to 4.
March 22, 2018 – Utah, Washington state and Florida have all recently mandated that patients be notified of their breast density after undergoing screening mammograms.
Utah’s bill, House Bill 258, amends a 2012 law that previously did not require patient notification, but encouraged it and offered suggested language to include in a patient’s mammogram results. The amendment not only requires breast density notification, but also clarifies the language to be used in notification. Utah Gov. Gary Herbert signed the amendment into law this month, and it takes effect May 8, 2018.
Washington state Governor Jay Inslee recently signed Senate Bill 5040 into law, and it will take effect Jan. 1, 2019. Unlike other state laws, every patient must be notified of their breast density after screening mammography, regardless of their classification. Patients with heterogeneously dense or extremely dense breast tissue will receive specific notification about its effects on their mammogram and cancer risk factors.
Florida’s Senate Bill 164, which was unanimously passed by the House and the Senate, requires facilities performing mammography to notify patients of their breast density if they are found to have heterogeneously dense or extremely dense breast tissue. Florida Gov. Rick Scott is soon expected to sign the bill into law, and it will take effect July 1, 2018.
"I am pleased that the reporting of dense breast tissue as part of a patient's mammography screening results will now be standardized across the state of Florida. This information will lead to informed conversations between patients and healthcare providers about a woman's cancer risk and screening options, " reported Florida State Sen. Denise Grimsley (R-D26), who championed the bill after her constituent, Debbie McCullough of Lake Placid, Fla., was diagnosed with breast cancer within months of her regular mammogram.
While all breasts are made of glands, fibrous tissue and fat, dense breast tissue has more glands and fibrous tissue than it does fat. Dense, fibroglandular tissue is normal and affects about 50 percent of women under age 50. Breast density is determined during a screening mammogram and is classified as either fatty, scattered, heterogeneously dense or extremely dense. Those with heterogeneously dense or extremely dense breast tissue have cause for concern, as dense tissue makes reading mammograms more difficult because both tumors and dense tissue appear white on the scans. Additionally, dense tissue increases a patient’s breast cancer risk by four to six times.
Many of these breast density reporting laws would not have passed without the work of Nancy Capello, Ph.D., who worked closely with Sen. Grimsley and Florida State Rep. Gayle Harrell (R-D83) to pass the bill. Connecticut’s 2009 bill — the first in the U.S. — was informed by Capello’s advocacy after her own diagnosis of stage 3c breast cancer, metastasized to 13 lymph nodes, that was discovered within weeks of her eleventh normal mammogram. Only at the time of her diagnosis was she informed of her breast density. This experience inspired her to found Are You Dense Inc. and Are You Dense Advocacy Inc.
For more information about breast density and notification: www.densebreast-info.org
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