Women in states with breast-density-reporting laws have a greater awareness of density-associated risks and more conversations with their providers regarding supplemental screening, a new U.S. survey shows.

Dr. Nancy M. Cappello, who led the survey, said, "Our national study results confirm that women who participate in mammography screening want information about their breast tissue following a mammogram."

"We call on FDA Commissioner Gottlieb to fulfill one of the FDA's major policy goals in 2018, the standardization of the reporting of breast density through regulatory changes in the Mammography Quality Standards Act (MQSA)," said Dr. Cappello, the director and founder of Are You Dense, Inc.

Mammography screening

"Finding breast cancer early should not be dependent on a patient's zip code," said Dr. Cappello. Breast density is a risk factor for breast cancer. And in dense breasts, small tumors may be missed on mammography, and the sensitivity of screening is diminished.

Dr. Cappello's team undertook a national survey of 1,500 women to examine the current level of women's knowledge regarding breast density; their desire to be directly notified of their breast density; their level of understanding of the implications of dense breasts on breast-cancer risk and risk-based screening; and the impact of state-level density reporting laws on women's level of breast density awareness and their engagement and conversations about supplemental screening with healthcare providers.

The divided the women into five equal groups of 300 women each, based on the characteristics of state density-reporting laws:

(1) Connecticut, where all women undergoing screening receive information about dense breast tissue;

(2) Five other states with similar characteristics;

(3) 16 states where only women with dense breasts receive information about dense breast tissue;

(4) Nine states where all women undergoing breast tissue received specific information regarding their density category; and

(5) 19 states with no density-reporting laws.

More than 75% of women in each of the five groups felt they were at least fairly knowledgeable about breast density, and 85%-90% agreed it is important for every woman to know her breast density type.

Most women in all groups (67%-80%) knew that dense breasts might mask cancers on mammography, but fewer than half of the women in four of the five groups knew that dense breast tissue also increases a woman's risk for developing breast cancer.

Few women (10%-22%) were aware of their own state's density-reporting law, and most (56%-71%) got their breast-density information from their health care providers, the researchers report in the Journal of the American College of Radiology, online October 1.

Significantly more women in states with density laws had been informed of their breast density in their mammography results letter (60% vs. 48% of women from states without reporting laws).

And women from states with reporting laws were significantly more likely to report that their provider talked with them about supplemental screening (67% vs. 53%, respectively).