The topic of breast density, according to Saini, has only become widely discussed among research circles in the last ten years, with some radiologists at odds on the best course of action to take. While some favor supplemental testing, others say what they look for in mammograms has to change.

With no consensus on a next step, many are hesitant to share their views on breast density with referring physicians and other non-radiologists for fear of spreading misinformation and causing patients potentially unnecessary anxiety.

Dr. Emily Conant, chief of the division of breast imaging in the University of Pennsylvania’s department of radiology and a consultant for iCAD Inc. and Hologic, is an advocate of informing women about their breast density and discussing the pros and cons of supplemental screening. She is concerned, however, that not all patients have access to supplemental screening due to additional costs.

“Women in some states have to pay out-of-pocket for supplemental screening. It’s distressing that supplemental screening may be more accessible to those that can afford it and not to those who can’t,” she said. “The potential additional cost, however, is not a good reason for physicians to not inform women about their breast density.”

In agreement with Conant is U.S. Senator Christine Rolfes who, like Rohrkaste, recently celebrated the passage of her own bill for breast density legislation in her home state of Washington. “When I first found out about breast density in 2012, the fight then was really about having insurance coverage for your basic mammogram, not anything more in-depth,” she said. “I think with the current state of breast density awareness and understanding, we’re starting at a very low level.”

Legislation
In 1994, Congress enacted the Mammography Quality Standards Act so that facilities nationwide would provide uniform quality standards to ensure early detection. Breast density, a little discussed topic at the time, was not included in these regulations.

That was supposed to change in 2011 when the MQSA committee of the FDA agreed to incorporate breast density assessment into MQSA standards. But seven years later, no changes have been made, a fact that boils the blood of Nancy Cappello, Ph.D., a survivor of stage 3C breast cancer whose own breast density experience propelled her to help pass the first state law in Connecticut in 2009 and found the nonprofits, Are You Dense Inc. and Are You Dense Advocacy Inc.

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