Breast-Density Legislation — Practical Considerations

• Published in: The New England journal of medicine Vol. 372; no. 7; pp. 593 - 595
• Main Authors: Slanetz, Priscilla J, Freer, Phoebe E, Birdwell, Robyn L
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 12-02-2015
• Subjects: Breast - anatomy & histology; Breast cancer; Breast Density; Breast Neoplasms - diagnostic imaging; Breasts; Early Detection of Cancer - economics; False Positive Reactions; Female; Health risk assessment; Hormone replacement therapy; Hormones; Humans; Legislation; Legislation, Medical; Mammary Glands, Human - abnormalities; Mammography; Patients; Physicians; Ultrasonic imaging; Ultrasonography; United States; Women; United States; United States > US; Connecticut
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMp1413728

A grassroots movement to inform women about their breast density has resulted in laws in 20 states mandating provision of that information. But the ability to detect breast cancer is affected by many factors, and evidence supporting supplemental screening is lacking.
Ever since Nancy Cappello, a Connecticut woman who hadn't been told that her mammograms showed dense breast tissue, was diagnosed with stage 3 breast cancer in 2004 and advocated for a new state law, there's been a growing movement to educate women about breast density and the potential role of supplemental screening in early cancer detection. Cappello's state was the first to pass a law requiring physicians to offer supplemental whole-breast ultrasonography to women with dense breasts — defined as containing more than 50% fibroglandular tissue — and mandating that insurers cover the additional screening.
Since then, the number of . . .