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Breast density inform inconsistency delivers confusion

July 17, 2014
From the July 2014 issue of HealthCare Business News magazine

By JoAnn Pushkin

We have reached the tipping point. We have reached the tipping point. By population, over fifty percent of American women now live in states that require breast density information be provided to them in the letter they receive after their mammogram. Nineteen states have now enacted some variation of mandatory inform. But the notification women receive varies state to state, with the level of detail differing and not necessarily consistent with the information to be discussed with their physicians.

Individual state reporting standards have resulted in inconsistent notification. The specificity and depth of density information a woman receives will depend on what is required in her home state. For instance, in some states women receive only general information about breast density, while in other states, women receive clear and unambiguous notification that they have dense breasts.

As an example, consider the difference in the official wording between neighboring New York and New Jersey notification:

New York

Who receives:
Patients with heterogeneously or extremely dense breasts.

Notification required: Your mammogram shows that your breast tissue is dense. Dense breast tissue is very common and is not abnormal. However, dense breast tissue can make it harder to find cancer on a mammogram and may also be associated with an increased risk of breast cancer. This information about the result of your mammogram is given to you to raise your awareness. Use this information to talk to your doctor about your own risks for breast cancer. At that time, ask your doctor if more screening tests might be useful, based on your risk. A report of your results was sent to your physician.

New Jersey

Who receives:
All patients.

Notification required: Your mammogram may show that you have dense breast tissue as determined by the Breast Imaging Reporting and Data System established by the American College of Radiology. Dense breast tissue is very common and is not abnormal. However, in some cases, dense breast tissue can make it harder to find cancer on a mammogram and may also be associated with a risk factor for breast cancer. Discuss this and other risks for breast cancer that pertain to your personal medical history with your health care provider. A report of your results was sent to your health care provider. You may also find more information about breast density at the website of the American College of Radiology, www.acr.org. In 2012, New York became the first state to enact a law providing for personal density notification.

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