27 September 2011

IS NEW BREAST CANCER BILL HELPING PATIENTS OR CAUSING UNDO ANXIETY?

Story first appeared in the Traverse City Record-Eagle.

It took seven years of annual mammograms and a cancer diagnosis for Amy Colton to learn something her doctors had realized for the beginning: Her breast tissue is so dense that it could have masked tumors on earlier exams.

She requested a copy of the report send from her radiologist to her primary care physician, and every single one said, “Patient has extremely dense breast tissue.” The registered labor and delivery nurse was really outraged that she didn’t know this.


About 40 percent of women over 40 have breast tissue dense enough to mask or mimic cancers on mammograms, but many of them don’t know it. Mammogram providers in California will be required to notify those patients, and suggest that they discuss additional screening with their doctors based on their individual risk factor, if Gov. Jerry Brown signs a bill that the Legislature passed this month. Similar laws have passed in Texas and Connecticut in the past two years but no data is available yet from either state on the effect of the legislation.

Researcher studying breast density, a relatively young field, said such requirements may end up causing undo anxiety in millions of women and lead to unnecessary and expensive ultrasound or MRI screening.

The California Medical Association, which represents 35,000 doctors, recommended a public education campaign instead of individual notifications, and said there isn’t enough evidence to support the idea the extra money spent on additional screening will save more lives.

Those test could cost the state more than $1 billion, and may women wouldn’t be able to afford them, said a professor of radiology and chief of breast imaging.

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