More States Consider Breast-Density Notification Legislation

August 8, 2012 — Momentum is building for states to pass legislation requiring health care providers to notify women if dense breast tissue is detected during a mammogram, the Wall Street Journal reports.

Last month, New York became the fourth state -- after Connecticut, Texas and Virginia -- to require that radiologists inform women if they have dense breasts when delivering mammogram results. Similar legislation is pending in a dozen states and Congress.

Studies have shown that women with dense breasts are four to six times more likely than other women to develop breast cancer, according to the Journal. Other studies have found that mammograms missed 60% of cancers in women with the densest breast tissue that were detected by ultrasound.

Some physicians who support notification bills say women with dense breasts should be informed so they can decide whether to receive regular ultrasound screening. They face opposition from insurers and major medical groups, who argue that mandated notification could raise health care costs and unnecessarily concern women.

The American College of Radiology says that there is insufficient evidence to recommend routine ultrasound screening for women with dense breast tissue, while the American College of Obstetricians and Gynecologists says it is up to radiologists to decide whether mammograms are sufficient.

Connecticut Study

Connecticut -- which in 2009 became the first state to pass a notification bill -- also requires insurers to cover the cost of an ultrasound for women with dense breast tissue. A analysis of 78,000 Connecticut women found that about half of those with dense breast tissue -- 8,651 women -- opted for an ultrasound, leading to the detection of 28 cancers that were not found by mammograms.

According to the analysis, the additional screening cost $2.15 million, or $110,000 for each cancer found. However, treating cancer at its early stages often is more cost-efficient than late-stage treatment, noted Jean Weigert, an executive with the Radiological Society of Connecticut who initially opposed the bill (Beck, Wall Street Journal, 8/6).