Relates to the duties of providers of mammography services to notify and inform patients if a mammogram demonstrates dense breast tissue

Summary of provisions

Section one amends the public health law by adding a new section 2404-c which requires mammography providers to include the following notification in the summary of the mammography report provided to patients who have dense tissue as defined in the bill:

Your mammogram shows that 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 on a mammogram and may also be associated with an increased risk of breast cancer.

This information about the result of your mammogram is given to you to raise your awareness. Use this information to talk to your doctor about your own risks for breast cancer. At that time, ask your doctor if more screening tests might be useful, based on your risk. A report of your results was sent to your physician.

Dense breast tissue shall mean heterogeneously or extremely dense tissue as defined in nationally recognized guidelines or systems for breast imaging reporting of mammography screening, including, but not limited to, the Breast Imaging Reporting and Data System (BIRADS) of the American College of Radiology, and any equivalent new terms, as such guidelines or systems are updated.

Section two sets forth the effective date as the one hundred eightieth day after it shall have become a law.

Existing law

There are no requirements in law for patients to be alerted to breast density.

Justification

One woman is diagnosed with breast cancer every three minutes, and one woman dies of breast cancer every 13 minutes in the United States. Cancer is four to six times more likely in women with dense breast tissue and 40% of women have dense tissue. According to a 2010 study published in the Annals of Surgical Oncology, 71% of all breast cancers occur in women with dense breast tissue. Mammograms fail to

detect about half the tumors present in dense breast tissue as dense tissue obscures the presence of the tumors. Follow-up studies after a similar dense breast tissue law passed in Connecticut in 2009 show that for women with dense tissue, the addition of a screening ultrasound nearly doubles the number of cancers found by mammography alone. In New York State, that number extrapolates to at least 2000 cancers a year in women who are told their mammogram results are "normal/negative," but who, in actuality, have invasive breast cancer. Missed cancers, growing undetected until at a later stage, are less treatable, least survivable and most expensive to treat.

Over 20 years ago, elected officials and medical experts reached a consensus that early breast cancer detection saved lives and states began requiring insurance coverage for mammograms. In order to ensure that patients received information about relevant mammographic findings, a federal law was enacted requiring a mammography report be issued to patients to help them partner with their physician in their health care vigilance.

A woman's breast density is determined through the mammography exam. Breast density not only dramatically compromises the effectiveness of a mammogram, but is, in and of itself, a risk factor for developing breast cancer. Women with dense breasts have a greater risk of developing breast cancer than those who have a first degree relative who have had the disease. Unfortunately, there is currently no protocol for density information to be shared with patients. The mammography reports to patients citing a "normal" finding - when the radiologist does not know, with any reasonable certainty what is lurking behind dense tissue - give women a false sense of security.

Now, twenty years later, states are recognizing that, for a significant percentage of women, the mammography notification requirements are not sufficient. The report a woman receives after her mammogram is required to be a summary, in lay language, of her mammographic findings. Information about breast density is a material medical finding which must be shared with patients. This legislation will give women with dense tissue the information to talk to their physician about getting adequate baseline and follow-up screening. Without it, women with dense tissue may be effectively denied equal access to early cancer detection without even knowing it.

Legislative history

New bill.

Fiscal implications

None.

Effective date

This bill takes effect on the one hundred eightieth day after it shall have become a law.