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Doctors’ Groups Oppose CA Breast Density Bill

June 23, 2011
Written by: , Filed in: Breast Imaging
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It seems a good idea: requiring that women who undergo mammograms be told if they have dense breast tissue. After all, dense tissue may make mammograms difficult to read, sometimes masking cancer.

So why do the California Radiological Society, the California Medical Association, the American Congress of Obstetricians and Gynecologists, and several other medical societies oppose proposed California legislation that requires just that?

Balazs Imre Bodai, MD, director of the Breast Health Center for Kaiser Permanente in Sacramento, California, said, as quoted by Medical News Today:

This legislation outlines a course of action that is vague and in many cases not necessary.

It should be noted that, according to HealthImaging.com, several medical organizations support the bill, including the California Nurses Association, the Breast Cancer Fund, and the Association of Women’s Health, Obstetric and Neonatal Nurses.

The bill is Senate Bill 173. It has passed the California Senate and is awaiting action in the House. The bill would require that, following a mammogram, individuals with dense breast tissue be told that they have dense breast tissue, that dense breast tissue can obscure cancer and other abnormalities on a mammogram, and that they may wish to discuss with their doctors the potential value of additional screenings.

So what’s the problem? The California Medical Association (CMA) points out that the grading of breasts according to density is subjective, leaving doctors open to lawsuits if patients with breasts not classified as “dense” are later diagnosed with breast cancer.

“Because the scope of who must receive the notice is so broad,” says the CMA on its Web site, “women will be ‘scared’ into thinking they need these expensive additional screenings when it isn’t at all warranted.” The CMA also says “the only supportable portion of the bill, that guaranteeing that carriers pay for these screenings should they be necessary, was taken out of the bill.” So women may have to pay out of pocket for additional tests—ultrasound or MRI—that they may think they need.

Besides, said James G. Hinsdale, MD, president of the CMA, “As part of the mammography report, the radiologist already reports density information to the referring physician. The patient’s physician should consider dense breasts as a factor along with other risk factors.”

In Texas, Governor Rick Perry signed a similar bill into law last week. The Texas law does suggest that women with dense breasts be told: “Dense breast tissue, in and of itself, is a relatively common condition. Therefore, this information is not provided to cause undue concern, but rather to raise your awareness and to promote discussion with your physician regarding the presence of other risk factors, in addition to dense breast tissue.”

Connecticut enacted similar legislation in 2009.

The California bill is certainly well-intentioned. But it also seems likely to create unintended consequences. Tough call.

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2 Responses to “Doctors’ Groups Oppose CA Breast Density Bill”

  1. Lori on June 26th, 2011 at 9:36 am

    I am a 46 year-old woman who was diagnosed with stage 4 breast cancer after my BIRADS 5 breasts obscured a 3cm cancer. If I had been advised by my physician that I should seek alternative scanning methodologies, I would have paid for it and I might have more than 2 years left to live.

    It must be easy for radiologists to sit back and play games with our lives….wait until one of your wives or daughters fall sick because of your insensitivity…with late-stage breast cancer….

    Radiologists in their white castles continue to work hard to keep women sick. Radiologists don’t seem to have any form of conscience….At least there are some radiologists in this country/world who disagree with you.

    We will do everything we can to show the world how wrong you are.

    Lori Jackson
    St. Louis, MO

  2. Radiology Daily»AlertArchive » California OKs Dense Breasts Notification Bill on September 15th, 2011 at 10:03 am

    […] bill passed the Legislature on Monday, despite opposition from the California Radiological Association and California Medical Association, among other […]