NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A9586D
SPONSOR: Jaffee TITLE OF BILL: An act to amend the public health law, in relation to
supplemental screenings
PURPOSE OR GENERAL IDEA OF BILL: This bill requires specific written
notification to the patient of a finding of dense breast tissue on a
mammogram, an explanation of what that means and a recommendation to
consult with the patient's physician about additional screening.
SUMMARY OF SPECIFIC PROVISIONS: Section one amends the public health
law by adding a new section 2404-c which requires mammography providers
to include the following information in the summary of the mammography
report provided to patients who have dense tissue as defined in the
bill:
Your mammogram shows that your breast tissue is dense. Dense breast
tissue is very common and is not abnormal. However, dense breast tissue
can make it harder to find cancer on a mammogram and may also be associ-
ated with an increased risk of breast cancer.
This information about the result of your mammogram is given to you to
raise your awareness. Use this information to talk to your doctor about
your own risks for breast cancer. At that time, ask your doctor if more
screening tests might be useful, based on your risk. A report of your
results was sent to your physician.
Dense breast tissue shall mean heterogeneously or extremely dense as
defined in nationally recognized guidelines or systems for breast imag-
ing reporting including, including, but not limited to, the Breast Imag-
ing Reporting and Data System (BIRADS) of the American College of
Radiology.
Section two sets forth the effective date as the one hundred eightieth
day after it shall have become a law.
EXISTING LAW: There are no requirements in law for patients to be
alerted to breast density.
JUSTIFICATION: One woman is diagnosed with breast cancer every three
minutes, and one woman dies of breast cancer every 13 minutes in the
United States. Cancer is four to six times more likely in women with
dense breast tissue and 40% of women have dense tissue. According to a
2010 study published in the Annals of Surgical. Oncology, 71% of all
breast cancers occur in women with dense breast tissue. Mammograms fail
to detect about half the tumors present in dense breast tissue as dense
tissue obscures the presence of the tumors. Follow-up studies after a
similar dense breast tissue law passed in Connecticut in 2009 show that
for women with dense tissue, the addition of a screening ultrasound
nearly doubles the number of cancers found by mammography alone. In New
York State, that number extrapolates to at least 2000 cancers a year in
women who are told their mammogram results are "normal/negative," but
who, in actuality, have invasive breast cancer. Missed cancers, growing
undetected until at a later stage, are less treatable, least survivable
and most expensive to treat.
Over 20 years ago, elected officials and medical experts reached a
consensus that early breast cancer detection saved lives and states
began requiring insurance coverage for mammograms. In order to ensure
that patients received information about relevant mammographic findings,
a federal law was enacted requiring a mammography report be issued to
patients to help them partner with their physician in their health care
vigilance.
A woman's breast density is determined through the mammography exam.
Breast density not only dramatically compromises the effectiveness of a
mammogram, but is, in and of itself, a risk factor for developing breast
cancer. Women with dense breasts have a greater risk of developing
breast cancer than those who have a first degree relative who have had
the disease. Unfortunately, there is currently no protocol for density
information to be shared with patients. The mammography reports to
patients, oiling a "normal" finding -when the radiologist does not know,
with any reasonable certainty what is lurking behind dense tissue - give
women a false sense of security.
Now, twenty years later, states are recognizing that, for a significant
percentage of women, the mammography notification requirements are not
sufficient. The report a woman receives after her mammogram is required
to be a summary, in lay language, of her mammographic findings, Informa-
tion about breast density is a material medical finding which must be
shared with patients. This legislation will give women with dense tissue
the information to talk to their physician about getting adequate base-
line and follow-up screening. Without it, women with dense tissue may
be effectively denied equal access to early cancer detection without
even (mowing it.
PRIOR LEGISLATIVE HISTORY: New bill.
FISCAL IMPLICATIONS: None.
EFFECTIVE DATE: This bill takes effect on the one hundred eightieth
day after it shall have become a law.
