As of January 1, 2014, the state of Illinois will require health facilities that provide mammograms to notify women if they have dense breast in accordance with Senate Bill SB2314. Illinois is one of at least 28 states that either are working on legislation or have already passed it. Minor details of breast density legislation differ by state. For example, Illinois is one of the only three states that currently mandate insurance reimbursement for supplemental screening exams for women with dense breasts.
A patient is considered to have dense breasts when the radiologist describes breast tissue as “heterogeneously dense” “or extremely dense” using the terminology provided by the Breast Imaging Reporting and Data System (BI-RADS) classification system copyrighted by the American College of Radiology. About 50 percent of all women who get annual screening mammograms have dense breasts by this definition. To address the requirements of state law, a patient with dense breasts will receive the following statement in their letter following a mammogram at Centegra Health System.
Your mammogram shows that your breast tissue is dense. Dense breast tissue is very common and is not abnormal but dense breast can make it harder to find cancer on a mammogram. Also, dense breast tissue may tissue increase your breast cancer risk. This information about the result of your mammogram is given to you to raise your awareness in accordance with the state of Illinois requirements. Use this report when you talk to your doctor about your own risks for breast cancer, which includes your family history. For more information about breast density you may speak with your doctor. You may also visit centegra.org/breastdensity for more information.
After receiving this letter, we anticipate patients will have questions about the significance of breast density. The California Breast Density Information Group (CBDIG) developed a website in response to new breast density legislation to assist referring physicians and radiologists. The website’s ”for health providers” tab provides a flow chart for physician reference. The CBDIG is composed of breast radiologists and breast cancer risk specialists from academic and community-based practices within California.
Centegra Health System has created the patient-friendly webpage which answers patient’s most Frequently Asked Questions. It also provides a web form where patients can ask questions to receive a response from a provider at the Centegra Gavers Breast Center.
Your patient may also ask about supplemental screening (a test in addition to a routine annual digital mammogram), which has risks and benefits. Centegra Health System currently offers digital breast tomosynthesis (3-D mammography) at the Centegra Gavers Breast Center for women who have dense breasts. Tomosynthesis is a promising new imaging modality that may increase cancer detection and reduce recall rates when compared to standard digital mammogram. This new technology captures multiple images of the breast at different angles to provide a reconstructed 3-D image of the breast. This allows the radiologist to evaluate the breast in one-millimeter slices. Digital breast tomosynthesis can sometimes find evidence of breast carcinoma that is obscured by overlapping breast tissue. Patients with dense breasts may benefit from tomosynthesis screening.
We look forward to partnering with you to continue to deliver the highest quality care possible to our patients. We will keep you informed of any new developments about this issue and we always welcome feedback about how we may better serve you and our patients. Please forward physician questions and comments to firstname.lastname@example.org.
Thank you!Elissa Brebach, M.D. Section Chief Mammography Centegra Gavers Breast Program