The California Medical Association (CMA) has joined with the American Congress of Obstetricians and Gynecologists – District IX, the California Radiological Society, the Medical Oncology Association of Southern California and the Association of Northern California Oncologists to oppose a bill that would require physicians notify mammography patients with highly dense breasts about the density of their breast tissue and the possibility that they may require additional imaging services (including ultrasound or MRI).
While the intent of the bill (SB 173) is to give women more power and control over their health, the legislation is vague and would impose undue cost burdens on the patient. Because high breast density is not currently by itself a risk factor for cancer in medical guidelines, in cases where prior authorization is required for additional screening, the tests may not be covered.
"This legislation outlines a course of action that is vague and in many cases, not necessary," said Ernie Bodai, M.D., director of Breast Surgical Services at Kaiser Permanente in Sacramento and creator of the breast cancer stamp. "Many of my colleagues and other major physician organizations have examined the intent, the science and the cost of this bill and find it to be lacking."
For the state to mandate that information be provided to patients, the information must be clear. While significant data has been gathered, there is not yet clarity on what "dense breasts" means and what should be done clinically. CMA doesn't believe it makes sense to mandate language that suggests women may need additional screening without this medical clarity.
"As part of the mammography report, the radiologist already reports density information to the referring physician," said CMA President James. G. Hinsdale, M.D. "The patient's physician should consider dense breasts as a factor along with other risk factors, such as age, history of breast cancer in family and prior mammograms."
Data is voluntarily being collected through the national American College of Radiology Breast Imaging Reporting and Data System system to enable data analysis so that it will become clearer about what actions should be taken in the case of high breast density. Once data is sufficient, professional medical guidelines will change to reflect this new information.
More information on this and other bills of interest to physicians is available at CMA's issues database.
Contact: Carolyn Ginno, (916) 551-2547 or firstname.lastname@example.org.