A few years ago, some states in the U.S. began mandating that if a woman is found to have dense breast through a screening mammogram, she should be notified of this. Dense breasts can make it more difficult to detect tumors and, for some women, may increase the risk of developing breast cancer.
The intent was that this type of notification would give women the information they need to have a discussion with their physician about if they should undergo further testing. However, many questions have come up about the utility of such a law and how it is implemented.
Currently, 17 states have breast density notification laws and 15 are working on passing such a law. But not all states send out the same type of information letter and that is where there may be problems. I wrote an article for
Diagnostic Imaging, a website for radiologists, for which I interviewed Richard Frank, MD, PhD, who is a founding member of the Qualitative Imaging Biomarkers Alliance of the Radiological Society of North America. In the article, Dr. Frank said that some states are doing a much better job of notifying women than others. There are letters that may cause more confusion than anything else:
Such letters say, “If you have dense breasts, and then what the options are. So the woman is going to look at that letter and say, ‘why did I receive this letter?’” It doesn’t tell her if she does or doesn’t have dense breasts, nor does it inform her of her particular situation."
However other states, such as Michigan, distribute much clearer letters:
“You’re receiving this letter because your breast tissue is dense. Dense breast tissue is very common and is not abnormal. However, dense breast tissue can make it harder to find cancer through a mammogram”
As Dr. Frank said, this type of letter is direct, it explains why the woman is receiving the letter and gives her information on what steps she may want to take given that she now has been informed of the situation and risks. Dr. Frank believes that a federal letter, the same letter sent to all women regardless of their state, is what is needed for this type of program to be successful.
Have you ever received such a letter? Was it helpful?
To find out where your state stands in terms of breast density notification laws, you can visit
Are You Dense, where there is an interactive map that details which states are actively pursuing such a law or have enacted one.
