More than 40% of American women age 40 and older have dense breast tissue, according to the National Cancer Institute. This type of tissue can make cancer harder to spot on mammograms and is itself associated with a higher risk of cancer. For some, additional screening may be appropriate.
Two kinds of legislation can help drive supplemental imaging for women with dense breasts - notification laws that require that facilities tell women when dense breast tissue is found by a radiologist on a mammogram and insurance mandates that require coverage of the follow-up tests - according to researchers from the Penn State College of Medicine.
In a study of 12.6 million de-identified health records of American women between the ages of 40 and 64 published in JAMA Network Open, the research team found that both forms of legislation independently led to modest increases in follow-up imaging tests like ultrasounds and magnetic resonance imaging (MRIs). However, insurance coverage mandates had nearly four times the impact, associated with roughly 47 additional ultrasounds per 1,000 women screened compared to 13 more from notification laws.
"Notification opens the door for patients to discuss breast density and supplemental screening with their healthcare provider, but it's not enough if we're trying to lower barriers for patients," said senior author Chan Shen, Howard E. Morgan Professor in Surgery and professor of public health sciences at Penn State College of Medicine. "This is the first large nationwide study that examined the influence of notification laws and insurance coverage independently on supplemental imaging whereas prior studies have often mixed these two factors together."
