Arizona Senate Bill 1225 requiring dense breast notification was recently signed into law. Titled Mammography results; report to patient law, the law goes into effect on October 1, 2014. It requires health care facilities performing mammographies to include a woman’s breast density classification in the summary report sent to the patient after her mammogram.
Women whose results are negative (no breast cancer found) but have dense breast tissue, must be notified of the condition, which can make it more difficult to identify breast cancer. The women are encouraged to discuss the issue with their health care provider and consider additional breast cancer screening options.
Northern Arizona Radiologist Stephen V. Ward, M.D., said radiologists have routinely reported breast density to patients’ referring physicians for years. However, up until now, it has not been a part of the standard results letter that women receive if their mammogram is negative.
“We’re ahead of the game,” said Ward. “We’ve been providing dense breast reports to our mammography patients for several months now, so patients and their referring physicians should already be used to the new information.”
Dense breasts are less fatty and have more connective tissue, which appears white like tumors, and therefore may be more difficult to detect. Ward emphasized that while breast density is completely normal and hasn’t yet been directly linked to an increased risk of death from breast cancer, it is an important factor that can impact a woman’s overall risk of getting breast cancer.”
“The patient is now aware that while her mammogram is negative, having dense breast tissue might make it more difficult to detect cancer,” explained Ward. “This allows the patient to discuss the pros and cons of additional screening options with her physician in a balanced, informed manner.”
Northern Arizona Radiology’s mammography summary report language will match that required by the new legislation:
“Your mammogram indicates that you have dense breast tissue. Dense breast tissue is common and is found in fifty percent of women. However, dense breast tissue can make it more difficult to detect cancers in the breast by mammography and may also be associated with an increased risk of breast cancer. This information is being provided to raise your awareness and to encourage you to discuss with your health care providers your dense breast tissue and other breast cancer risk factors. Together, you and your physician can decide if additional screening options are right for you. A report of your results was sent to your physician.”
According to the American College of Radiology, more than 40 percent of all U.S. women — approximately 40 million — are considered to have dense breasts, and women with dense breast tissue have an increased risk of developing breast cancer. The Susan G. Komen Foundation Risk Factors and Prevention Guide cites clinical studies showing women with dense breast are up to five times more likely to get breast cancer compared to women with low breast density. “Having dense breasts plus one or more additional risk factors for breast cancer may justify the need for supplemental screening after mammography,” said Ward.
Supplemental screening at NAR includes breast MRI, breast specific gamma imaging (nuclear imaging with a specialized camera and tracer injection) and breast ultrasound. When used in conjunction with mammography, such tests may find hidden cancer, leading to improved early detection.