New York has become the fourth state to issue new guidelines to mammography providers, requiring they tell patients about a common, but ambiguous problem.
Women who were cleared of cancer in a mammography test will now have to be told if they have dense breast tissue, which could mask a tumor. The new regulation requires mammography reports to advise women with dense breast tissue to discuss additional screening, such as an ultrasound exam.
Supporters of the new law say 40 percent of women have dense breast tissue, which has less fat and more connective tissue and appears white on a mammogram.
“The mammogram providers tell physicians, but all too often the patients themselves don’t find out,” said Rockland County Assemblywoman Ellen Jaffee (D-95th), a co-author of the bill. “It gives them a false sense of security.”
Both houses of the Legislature passed the bill unanimously, and Gov. Andrew Cuomo has signed it into law. New York’s main physicians’ society and radiologists’ organization also supported the bill.
But the American College of Radiology expressed concerns about unintended consequences, such as an increased demand for more expensive ultrasound or magnetic resonance imaging, or MRI, screening. The organization said both techniques result in additional false positives and there's no data showing ultrasound or MRI screening saves lives.
Connecticut, Texas and Virginia have similar notification laws. California Governor Jerry Brown has vetoed a proposal that passed the legislature. Lawmakers there are trying to pass it again. The California Medical Society opposed the legislation, saying the warnings could create unnecessary anxiety.
Dr. Christine Ambrosone, an epidemiologist at Roswell Park Cancer Institute in Buffalo, said dense breast tissue is more common among younger women than older women. Among the latter, it’s considered a risk factor for cancer – though the biological mechanisms aren’t clear.
Ambrosone supports the idea of sharing more information with women, but she cautions there’s no objective standard for what constitutes “dense” breast tissue.
“When you get your cholesterol reading, it says, ‘This is your number. This is the ‘Safe’ range.’ We don’t have that now for breast density,” she said. “Still, just as with cholesterol, I would want to know, and what you do with that afterwards is between a woman and her physician.”
Previously, mammogram providers informed women’s doctors about the dense tissue, but didn’t necessarily say anything to patients.
Failure to carry out the measure could result in a fine of up to $2,000.
With the Associated Press