Understanding new breast density notification laws

The implementation of breast density notification laws will continue to be a major story heading into 2015, as it has been for the past few years. With 20 states having already enacted some type of notification law and more likely to follow, along with possible federal legislation, it will be important to truly understand the impact of this movement.

Two of the top stories this week attempt to shed some light on this question, with one trying to gauge patient response to a sample density notification and another assessing whether physicians are even prepared to have density discussions with patients.

Vivian M. Yeh, PhD, of the Icahn School of Medicine at Mount Sinai in New York City, and colleagues tackled the question of patient response in a study published online in the Journal of the American College of Radiology (JACR). Using an online service that paid participants for completing survey and opinion tasks, Yeh and colleagues exposed a group of 184 women over the age of 40 with no previous cancer diagnosis to a sample breast density notification report.

After reading the hypothetical report, a majority of respondents reported greater perceived risk and indicated they planned to undergo mammography and additional ultrasound screening. To the surprise of the researchers, minority participants and those who indicated a distrust of healthcare services, two groups that statistically use fewer healthcare resources, both signaled intention for ultrasound screening.

The sample report seemed to up the anxiety level of participants, though the authors noted that the study could not determine whether the participants’ stated screening intentions would correlate with screening behaviors.

While the work of Yeh and colleagues suggests that patient interest in the topic of breast density will be piqued by a notification, will their physicians be equipped to have a discussion on the topic? Another study published recently in JACR indicates there’s a good chance they aren’t.

Katherine A. Khong, MD, of the University of California, Davis, School of Medicine, and colleagues sent surveys to 174 internal medicine, family medicine and obstetric-gynecology outpatient physicians in California to determine their understanding of breast density risks and the notification law in California.

Of the 77 physicians who responded, 49 percent were not aware of the California law before completing the survey and only 6 percent said they were “completely comfortable” in answering patient questions about breast density.

But the physicians were willing to learn; according to the survey results, 75 percent said they were interested in educational presentations about breast density and the impact on screening.

These types of educational efforts will be important as notification laws spread around the country. If we are to see any benefit to these laws, patients and providers must understand the risk of dense breast tissue and be able to discuss appropriate screening options for each individual.

-Evan Godt
Editor – Health Imaging