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Virginia May Require Breast Density Notification

February 10, 2012
Written by: , Filed in: Breast Imaging, Practice Management
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Two bills requiring that radiologists directly notify women about their breast density after mammograms are rolling quickly through the Virginia Legislature.

Virginia Commonwealth University’s Capital News Service reports that the bills are identical. One originated in the House and the other in the Senate. Each body has approved its own version unanimously. Each bill has moved on to consideration by the other body.

Each bill requires that, after performing a mammogram, a radiologist must send the patient a letter about her breast density. Women with dense breasts would be told:

“Your mammogram demonstrates that you may have dense breast tissue, which can hide cancer or other abnormalities. A report of your mammography results, which contains information about your breast density, has been sent to your referring physician’s office, and you should contact your physician if you have any questions or concerns about this report.”

Currently, radiologists send reports, which include information about breast density, only to the referring physician. Whether to tell the patient about breast density is up to the physician.

Few women know their breast density. Nor does much of the public understand that dense breasts not only can make cancer more difficult to detect via mammogram but also themselves constitute a risk factor for breast cancer.

The driving force behind the Virginia bills is Cathryn Tatusko, a 56-year-old registered nurse who lives in Fairfax County, Virginia. In 2009, she was diagnosed with Stage III breast cancer that had gone undetected despite yearly mammograms—including one five months previously.

Her dense breast tissue masked the tumor, even in a mammogram performed the day of her diagnosis. Tatusko recounted her reaction:

I still so vividly recall the numbing fear I felt as I left my home one morning during that diagnosis week from hell, headed to the radiology facility, determined to pick up my old mammogram films to take as proof to the breast surgeon … that I could not possibly have breast cancer because the last films had been so recent.

Connecticut and Texas are the only states that currently mandate notification about breast density after mammograms. Several other states are considering such legislation; imagingBiz has a rundown here. We’ve reported on the legislative effort under way in Utah and on last year’s veto of a California bill.

imagingBiz quotes Carol Lee, MD, chair of the American College of Radiology Breast Imaging Commission, as saying that the ACR generally supports notification but is concerned about the wording:

Where we have a problem is when the language goes on to say a woman should have additional screening. We think a better approach is that it should generate a discussion with the woman’s health care provider.

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