How Effective Are Breast Density Notification Laws?

Written by Ronny Bachrach on April 27, 2015. Posted in Digital Radiography and PACS, RIS, Software

In recent years, the potential health risks associated with dense breast tissue have become a major topic of conversation among radiologists and other health care providers. States in the U.S. even passed new laws that require doctors to notify patients about the presence of dense tissue.

However, few organizations have examined the true effect of these alerts, which leads to the question: Are notification laws helpful?

Figuring out the real benefits of alerts
According to an article published in the New England Journal of Medicine, 21 states have passed laws that require doctors to notify women if their breast tissue is revealed to be dense through mammograms. Lead author Priscilla Slanetz, M.D., M.P.H., from Beth Israel Deaconess Medical Center, and her colleagues explained that these laws may be well-intended, but could increase the frequency of unnecessary medical imaging exams and false positive reports.

"The movement to inform women about their breast density has been driven primarily by grassroots organizations and laypeople," wrote the authors, quoted by AuntMinnie.com. "The medical community has been more cautious because the ability to detect breast cancer is affected by many factors beyond the limitations of screening mammography, and evidence supporting supplemental screening is lacking.

Slanetz was instrumental in developing Massachusetts' breast density legislation, which went into effect in July 2014. The law does not mandate additional screening in the presence of dense tissue, but encourages patients to meet with their primary care physicians and discuss options for intervention. This allows doctors to adopt the modality they deem to be most effective, such as abbreviated MR or digital breast tomosynthesis.

Clinical evidence suggested that the breast cancer risk of women with dense tissue is 1.2 to 2.1 times that of individuals with average tissue. In addition, the overall risk increases if a woman has a relative with breast cancer or carries a BRCA-1 or BRCA-2 mutation, which raises risk by a factor of eight.

While notification laws may not be completely effective in improving diagnostic imaging results, they do create opportunities for physicians to communicate with patients more frequently about clinical issues. This could be crucial in California, where researchers found many doctors are behind on the state's own mandates for density notifications.

Letting doctors know about density laws
A new study from the University of California-Davis showed that almost 50 percent of primary care providers in the Golden State are still unaware of the notification law and are uncomfortable discussing density with patients. The results are set to be published in the March issue of the Journal of the American College of Radiology.

"Overall, the impact of the breast density legislation probably is not significant if primary care physicians are not educated or aware of it," lead author Kathleen Khong, M.D., a UC Davis radiologist and staff physician, said in a press release. "We should put some emphasis on educating the primary care physicians so that when they get questions from patients, they can be comfortable in addressing the issues."

Khong and her team surveyed 77 physicians regarding their knowledge about the existing law. They discovered that nearly half of the participants were unaware that the mandate even existed and only 32 percent had experienced any increase in their patients' concerns about dense breast tissue. Furthermore, the study revealed that 75 percent of subjects would like to receive additional education on the law and its implications for the health care industry.

With only 55 percent of California physicians feeling "somewhat comfortable" discussing breast density with their patients, there is a clear opportunity to develop more educational materials for both doctors and patients to learn about the risks of dense breast tissue.

Contact Viztek for more information.

Ronny Bachrach

Ronny Bachrach

Marketing Director at Viztek LLC
Responsible for all marketing activities including, press, advertising, trade show coordination, website management, dealer and customer communications.
Ronny Bachrach
Don't be selfish share with your friends...
Share on LinkedIn0Share on Google+0Share on Facebook0Tweet about this on TwitterEmail this to someoneBuffer this page
Sign up for our Newsletter

Contact Details