Breast Density Legislation Makes a Comeback on the California Ballot

This week, California (re)joined Michigan, Ohio, Florida, and Maine as one of a handful of U.S. states to put forth a bill that would notify women of their breast density when they receive the results of their mammograms. Similar legislation passed through both houses of the California legislature last year with only seven total dissenting votes, but it was vetoed by Governor Jerry Brown (D). According to the breast density advocate group Are You Dense, as many as 40% of all women have dense breast tissue, but fewer than 10% are informed of their breast density by their doctor. Furthermore, the group says, women with denser breast tissue are four to six times more likely to develop cancer and four times more likely to have a recurrence of breast cancer. “It’s the difference between early and late-stage cancer,” says Are You Dense founder Nancy Capello. “We are trying to give women access to early diagnosis.” According to Capello, herself a breast cancer survivor, women “can’t rely on the medical community” to standardize patient awareness on the issue of breast density, and thus legislation is needed to ensure their compliance on this critical health issue. “This is a major advancement in early detection work that we are doing,” Capello says. “Despite that, it’s remarkable that we have such non-support or opposition.” For dense-breasted women, mammography may be insufficient in detecting certain cancers; typically, when additional tests are needed, physicians will order MRI, molecular imaging, or ultrasound studies of the breast. At issue in some states where legislation is being considered are questions of insurance coverage for these adjunctive scans. Currently, only three states—Connecticut, Virginia, and Texas—have breast density notification laws on the books; only in Connecticut, Capello’s home state, does the measure mandate insurance coverage for secondary screening. A nationwide measure that would obviate the need for the smaller, individual state bills has been up for consideration in the U.S. legislature since 2011. Capello says that it’s not going to be enacted easily. “ACS is neutral on our legislative efforts, and Congress is neutral on our legislative efforts,” she says. “The majority of these [state] bills have no support from the Cancer Society nor [the Susan G.] Komen [For the Cure Foundation]. “This national push is because of women advocating for other women because the medical community failed to tell women of a critical health risk,” she says.