In 2015, my office was contacted by Congresswoman Gwen Moore, to request that I introduce legislation requiring notice to be provided to patients regarding findings of the condition of breast dense tissue as the result of mammography examinations. Moore indicated that a variation of the bill had been done on the federal level and that we needed to do something similar in Wisconsin. Also, of particular interest, to both the Congresswoman and me, were the disproportionate number of African-American women impacted by these findings.
During breast cancer screenings, there are a number of women who have test results that are difficult to read. When radiologists review breast images, they may score the density, the fibrous and glandular tissue of the breast, from 1 to 4 (lowest to highest) or a-d.
According to health care professionals, a problem arises in screening women with dense breasts for cancer because fibrous and glandular tissue produce cloudy-white, oddly shaped images in mammograms. Normal fat, by contrast, tends to appear dark gray or black in the images. The benign fibro-glandular material tends to mask cancer, making it hard for the radiologist to see. Additionally, breast density is believed to be the main cause of false negatives (when screening fails to detect cancer that is present) in mammography.
I moved forward with drafting the legislation, only to be contacted by two women’s’ issue advocacy groups asking that I hold off on introducing the bill.
I was surprised and didn’t understand the controversy. They indicated that doctors raised two concerns, increased reporting mandates and that the additional screenings that would be required could overwhelm medical resources. They asked that I wait until there was more information to support the necessity of notification of this condition.
I relented and agreed to wait. However, at the time I committed to memory data that I had read on the matter.
In 2015, the American Cancer Society estimated that 231,840 women would be diagnosed with breast cancer during that year. Of that number, they expected that 40,290 patients would die. Studies have found that in women older than 45 years, black women have a lower incidence of breast cancer but a higher mortality.
A lot has happened since that conversation 2 years ago. There are now 25 states that have passed similar legislation, and at least 5 states have bills pending. Most breast imagers believe knowledge about breast density is beneficial. It will help women’s in screening decisions and follow-up care.
Medical professionals have been grappling with and responding to this issue for years. The treatment is inconsistent from doctor to doctor or facility to facility. This week, Senator Alberta Darling (R-River Hills) and I introduced legislation to that seeks to make uniform the manner in which all impacted patients can learn of the initial determination of dense breasts. It will allow them to proactively, along with their doctors, make decisions about the next steps in their health care.
