Differences in Breast Density Awareness, Knowledge, and Plans

We read with interest the article by Kressin et al..¹ The study sought to determine the effects of state dense breast notification (DBN) laws on patient awareness relating to topics of masking, risk, and supplemental screening. One caveat is that not all 38 state laws² provide the same information or level of notification. It would have been informative if the study had distinguished between state DBNs that do provide personal notification and information on masking, risk, and supplemental screening vs. those that do not. For instance, six states (CT, TX, MD, NJ, MO, LA) require general information about breast density be provided to the patient without informing the patient if she, herself, has dense breasts. We hear from women in those states who assume they do not have dense breasts as the notification received does not detail that they do. Additionally, while all state laws except CT’s mention density as a (at least potential) risk factor, six state laws (CA, NV, SC, CO, WA, NM) do not provide unambiguous language about the masking effect of cancers due to dense tissue, and 23 state laws do not mention that supplemental screening may be a topic to discuss with a health provider. Some (e.g., UT, CA, MD, NV, NC) mention the ambiguous term “screening options” which women often interpret as mammography screening frequency. …