• National Breast Density Notification Amendment Advances

    August 13, 2013

    by Nancy Ryerson , Staff Writer

    The fight for breast density notification legislation has taken another step forward. Advocates proposed an amendment to the Mammography Quality Standards Act (MQSA) that would require that women screened for breast cancer be informed if they have dense breasts.

    Currently, 12 states have enacted breast density inform laws. But language in the inform letters vary among the states, and women who live in states without the laws are often left in the dark about their status. Breast density makes cancer very difficult to spot on a mammogram and raises a woman’s risk of developing breast cancer.

    “For example if you live in New York, you’ll get your results, but if you’re in New Jersey you won’t because their law hasn’t passed yet,” JoAnn Pushkin, who proposed the amendment, told DOTmed News. She’s the co-founder of Density Education National Survivors’ Effort. “And it can really be a question of life or death.”

    Pushkin approached the FDA about adding an amendment and learned, fortuitously, that the MQSA was up for reauthorization. Together with other advocates and radiologists, Pushkin succeeded in getting the agency to consider the regulatory amendment.

    She hopes the amendment will require notification in states that clearly and unambiguously tell a woman she has dense breasts, and for doctors to explain what that means. Less effective language, such as that sent out in Maryland, starts notification with “If your mammogram shows that your breast tissue is dense you should know…”, a potentially confusing message.

    “I’m hoping that it would be at least as stringent as the best state language, like the kind used in New York,” said Pushkin.

    Though recent studies have called ultrasound the best imaging method for dense breasts, Pushkin doesn’t think the notifications should include any further prescriptive advice beyond encouraging women to discuss further steps with their doctors.

    In December, the proposal will be submitted for public comment. Pushkin hopes to see the amendment incorporated some time in 2014.

  • Dense breasts may need more screening

    United Press International

    Women with dense or non-fatty breast tissue may need additional breast cancer screening, a U.S. researcher says.

    Dr. Roshni Rao, assistant professor of surgery at the University of Texas Southwestern Medical Center in Dallas, said one woman’s personal battle with breast cancer was the inspiration for Henda’s Law — a Texas law named for Henda Salmeron that requires women to be informed about their breast tissue’s density and the limitations of mammography in certain cases.

    Rao, Salmeron’s breast surgeon, said radiologists use a grading system to describe the density of breast tissue based on the amount of fat (non-dense) and connective (dense) tissue. Research is under way into why some women have denser breast tissue, but as women age, their breast tissue generally becomes more fatty, Rao said.

    “Breast tissue that has minimal or no fat may appear white, or dense, on a mammogram. This sometimes makes it difficult to identify cancers, which also typically appear as small white spots,” Rao said in a statement. “Many factors contribute to a woman’s risk of breast cancer. Having dense breast tissue may be one of them, but your doctor considers other factors — age at which a women had her first child, family history of cancer or age at the onset of menstruation, among others — when evaluating your risk and tailoring your screening program.”

    Digital mammograms may be best at finding cancer for women with dense breast tissue. Other tests, including breast magnetic resonance imaging and ultrasound and breast thermography, may be helpful, but only in addition to mammograms, Rao said.

    Copyright United Press International 2011