California Adopts Breast Density Inform Legislation

California’s Governor, Jerry Brown, has signed Senate Bill 1538 into law and expanded by several million the number of U.S. women who must be informed about their breast density status along with their mammogram results. California is the largest U.S. state in terms of population. In 2010, its population of women ages 40 to 74 was roughly 6.7 million, according to U.S. census data. About 40 percent of women have dense breast tissue, says patient advocacy group Are You Dense. If one assumes a mammography rate of 78.2 percent (data from Kaiser Family Foundation) holds true for this 40 percent of the mammography-eligible patient group in California, this means that the new law could affect more than 2 million women. Last year, the Governor vetoed similar legislation because the bill required women with dense breast tissue be told that additional screening would be beneficial. The California Medical Association (CMA) and others pointed out that this statement has not yet been proven by research. Furthermore, there is the potential that additional screening could actually harm more women than it helps by leading to more false positives and unnecessary biopsies. Senator Joe Simitian (D-Palo Alto) reintroduced the bill this year with language that corrected this issue and the CMA dropped its opposition. In addition, with the language around how women should be informed renegotiated, the bill also picked up support from the California Radiological Society, the California Nurses Association, Planned Parenthood Affiliates of California, the California Affiliates of the Susan G. Komen Foundation, and the Breast Cancer Fund, said the Are You Dense advocacy group in a press release issued on Saturday. The new law requires that after April 1, 2013, women with dense breast tissue who undergo a mammogram in California must be informed that:

1. They have dense breast tissue.
2. That dense breast tissue can make it harder to evaluate the results of a mammogram.
3. That it is associated with an increased risk of breast cancer.
4. That information about breast density is given to discuss with their doctor.
5. That a range of screening options are available.

California joins Texas, New York, Connecticut and Virginia in having a breast density inform law. Currently, similar legislation is either endorsed or in the process of being developed in 15 other states, according to Are You Dense. (Click here for advocacy map.) In addition, a U.S. House bill (H.R. 3102) was introduced a year ago by Rep. Rosa DeLauro (D-CT) that would cover women nationwide. As awareness of the breast density issue grows, the ACR has responded with patient education materials for imaging providers and referring physicians. To download the ACR's new breast density brochure for use with your patients, click here.