The Governor of Rhode Island has just signed the “Dense Breast Notification and Education Act,” bringing the total to seventeen states. Under Rhode Island law, all mammogram patients will be told their density classification according to the Breast Imaging Reporting and Data System (BIRAD). When a woman has dense breasts, an additional paragraph will be included adding that additional imaging may be recommended. This is the bill I spent years trying to enact in New Jersey, not the one we have now.
Every state with breast density inform laws, except New Jersey, has language that requires patients to be told when they have dense breasts. Previously, radiologists sent reports to referring doctors but they were not obligated to tell their patients. Only the newly enacted New Jersey law tells all women they may have dense breasts. I am just as unhappy as the critics who are asking why I initiated this bill.
I contacted Senator Weinberg in 2011 after reading about Connecticut’s new breast density inform law. For years, I had been looking at the breast density of my patients and recommending additional imaging when I thought their mammograms were inconclusive. I wanted to establish the standard of care I was giving as the standard for all radiologists. I have seen too many patients with dense breasts who came to me after being told their mammograms were negative, only to find cancers that were obscured on their mammograms by using a different imaging modality. While the New Jersey Senate passed a bill with appropriate language, the New Jersey Assembly responded to groups opposed to the bill. The result was a watered down law.
Now that we are putting the law into practice, we are seeing how the vague language is confusing and superfluous for both physicians and patients. I have to include the required language telling my patients they may have dense breasts even though my reports give specific density results.
Where do we go from here? We are looking into what must be done to amend the New Jersey bill. In the meantime, New Jersey physicians and patients must communicate with each other so women know if they have dense breasts and what action to take if they do.