On Monday, June 1, 2015, Michigan became the 21st state to enact a breast density notification law. The law requires mammography facilities to inform women of their breast density. Radiologists at MidMichigan Health have been reporting breast density for some time in the mammography radiology report. Patients also began receiving notification of their breast 
density in May 2015 in the mammography patient summary letter mailed to their home.
Why is breast density important? Continue reading.
My colleagues and I are deeply concerned about recommendations recently released by the U.S. Preventive Services Task Force (USPSTF) on screening mammography.
The new guidelines recommend that screening mammography is optional for women in their 40s, and that women in their 50s only receive mammography screening every two years, rather than annually, as is advocated by women’s health, oncology and radiology medical societies and accrediting bodies.
These recommendations, if enacted, will almost certainly result in thousands of breast cancer deaths per year and more extensive and expensive treatments, since cancer will be detected at a later point in time. What’s more, the guidelines do not recommend screening for women in their 40s, repeating the task force’s belief that the benefits of screening in this age group do not outweigh the purported harms of screening. Continue reading.
Many women don’t know that screening mammograms are now almost universally covered by health insurance, as they are considered an important part of disease prevention. For example, the Affordable Care Act requires most plans to cover screening mammograms every one to two years for women over 40 – with no cost sharing by the patient – in order to qualify as “minimum essential coverage.”
This is good news for the growing number of patients who have high deductible plans, because it means you can get your screening mammogram on schedule, instead of waiting to meet your yearly deductible first. And in most cases, you won’t have to pay a copay or coinsurance. Continue reading.
In the past few years there has been a surge in research in improving breast cancer screening. In particular, there has been a special interest in trying to improve detection of breast cancer in women with dense breasts. Studies have shown that performing breast ultrasound, MRI, or molecular breast imaging with a screening mammogram in women with dense breasts have detected more cancers. The drawback is that they also find many more benign masses, leading to more biopsies and false positives.
Breast density legislation is expected to pass in the state of Michigan which will require mammography facilities to inform women who have dense breasts. These women can then have a conversation with their physician about supplemental screening exams to have in addition to a mammogram. This is particularly true in women who have additional risk factors.
The easiest, least costly, and most available test without extra radiation is an ultrasound. Continue reading.
