New breast density notification law takes effect

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LA JOLLA, Calif. – California became the fifth state to force doctors to notify patients if any images from their annual mammogram showed dense breast tissue. A new California law went into effect Monday that will help in fight against breast cancer.

mammo“I would assume that a doctor would tell you that at the time of the mammogram,” said Martha Smith, a San Diego resident. “I think it’s a major issue and you certainly need to be informed.”

Dr. Vivian Lim of Scripps Clinic La Jolla said 40 to 50 percent of all women have what is considered dense breast tissue. It’s normal and does not mean you have cancer, but it does make it difficult for a mammogram to pick up abnormal cells.

“This white tissue is the same density as small mass,” said Lim. “You can imagine a small white mass is going to be hard to pick out against the backdrop of white tissue.”

On average, mammograms miss 10 to 15 percent of cancers and of those – half are due of dense tissues.

“We are hoping it doesn’t cause a panic,” Dr. Lim said.

Scripps performs about 50,000 mammograms a year.

The new law could potentially have half those women wanting follow ups with an ultrasound, which according to Dr. Lim is also not without its problems.

“It’s not regulated,” said Dr. Lim. “Ultrasounds are highly operator dependent.”

The key is getting checked every year cross checking with previous images for changes, especially if a patient falls into a high risk category.

“The technologist is key in finding little things and we’re talking a about a few millimeter abnormality and that’s tough,” she said.

As of now, ultrasound as a follow up to a mammogram is not standard procedure and therefore not automatically covered by insurance.

“Maybe more people that know about it would push insurance companies to make that part of the program going forward,” Smith said.

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