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NJ Breast Density Notice ‘A Good First Step’

January 28, 2014
Written by: , Filed in: Breast Imaging, Medical Ethics, Practice Management
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Last week, New Jersey became the 15th state to enact a law requiring that women who have mammograms be given information about breast density. But the language of the mandated notification left many of those who pushed for the law feeling lukewarm about it—at best.

Consider this comment from Laurie Scofield, founder of D.E.N.S.E. NJ, the New Jersey chapter of the Density Education National Survivors’ Effort:

The bill is a good first step. It took me a while to reconcile myself to that fact. It does raise awareness at a very high level, general level, but where it does fall short is, it doesn’t provide New Jersey women with enough information about their own medical condition to be their best advocate.

Scofield was quoted by DOTmed News.

The law provides that every woman who receives a mammogram in New Jersey receive general information about breast density, based on BI-RADS. It does not require that women with dense breasts be informed of such a finding. Instead, all mammogram recipients will receive the following notification:

“If your mammogram demonstrates that you have dense breast tissue, which could hide small abnormalities, you might benefit from supplementary screening tests, which can include a breast ultrasound screening or a breast MRI examination, or both, depending on your individual risk factors. A report of your mammography results, which contains information about your breast density, has been sent to your physician’s office, and you should contact your physician if you have questions or concerns about this report.”

An early version of the bill did require notification if breast density were found. But Scofield and DOTmed News said the New Jersey section of the American Congress of Obstetricians and Gynecologists lobbied to have that language deleted. The ob-gyn group feared that physicians would feel compelled to order additional scans for women with dense breasts just to avoid lawsuits.

Radiologists generally supported the original language. Stacey Vitiello, MD, a radiologist at Montclair Breast Center in Montclair, New Jersey, wrote a letter to legislators supporting “density notification which is clear, specific to the woman receiving the letter, and which creates an actionable alert that would provide the woman with the information about her own medical condition.”

Instead, she said, the law will now require New Jersey radiologists to lie to 10 percent of their mammography patients (the ones with fatty breasts) and provide misleading information to another 40 percent to 50 percent.

Some politicians will no doubt be baffled at her objection. For them, lying to 10 percent of their constituents and misleading another 40 or 50 percent is simply a good day’s work.

Related CME seminar (up to 24 AMA PRA Category 1 credits™): Chicago International Breast Course and The Society for the Advancement of Women’s Imaging

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