A bill pending before the state Legislature could lead to more breast cancer screening for women — especially Ashkenazi Jewish women — at higher risk for developing the disease.
But the bill, and its companion legislation, are stuck in committee with little chance they will be reported out this year.
S.B. 1332 — would require physicians to inform women who have mammograms of their breast density number. Women with so-called “dense breasts” are at high risk of developing breast cancer.
To complicate matters, a higher breast density can make detecting cancer on a mammogram more difficult.
Under the bill, “each mammogram would have the breast density formation based on the system established by the American College of Radiology,” said Geri Lynn Sarfert, legislative director to state Sen. Bob Mensch (R- Montgomery County) who is co-sponsoring the legislation.
“If [women] have a high breast density number they should consult with their doctor,” she added. Additional tests might be necessary.
The problem is paying for the tests, which is why the bill has companion piece of legislation S.B. 1333 — which would require insurance coverage for ultra-sound screening, MRI or other supplemental testing where necessary.
Both bills are currently bogged down in committees — 1332 in Public Heath and Welfare Committee and 1333 in the Banking and Insurance Committee. With time running out in the legislative session, chances are slim either bill will be acted upon this year.
“The insurance mandate is always a tough one to get through legislatively,” Sarfet said. “It definitely drives up insurance costs all around.”
Four states — Connecticut, New York, Texas and Virginia — already have laws similar to the bill pending here. Thirteen others introduced similar bills this year, according to JoAnn Pushkin, executive director of Are You Dense Advocacy, a private government relations group that supports breast density notification laws at the state level. “We call this explosion of legislation initiated by grass roots activists a ‘legislation tsunami.’ ”
According to Are You Dense Advocacy, 95 percent of all women over the age of 40 do not know their breast density, and less than 1 in 10 find out through their doctor.
But if they did know their density number and acted upon it, the results could be staggering.
“Connecticut was the first state to enact a breast density inform law in 2009,” Pushkin said. “A study was conducted … after a full year of the law’s enactment. The study reviewed data from 12 imaging sites, which resulted in 78,778 mammograms and 8,651 screening ultrasounds. The results surprised even the researchers. For dense breasted women, the addition of a screening ultrasound after mammography nearly doubled the number of cancers found by mammogram alone.”
Are You Dense Advocacy, Inc. is a nonprofit public charity that supports both state and federal legislative efforts. It is comprised of grass roots advocates — all volunteers — affected by later stage cancer diagnoses.
In Pittsburgh, Dr. Bill Poller, director of breast imaging for the West Penn Allegheny Health System, also supports breast density notification, but he thinks Pennsylvania should learn from states that already have the law.
For instance, he noted there’s a six-month wait in Connecticut for supplemental screening due to a lack of testing equipment and trained professionals to operate them.
And he warned that while supplemental testing does detect more cancer cells, it also registers many false positives.
“I support the concept, but there has to be strict guidelines, good equipment and reimbursements, Poller said. “It takes some time.”
Even if the bill passes, and Poller believes it eventually will, he called mammograms “the gold standard” for breast cancer detection and recommended women continue to get them before proceeding to supplemental tests.
“You can have a mammogram, then you branch and decide what to do after you have the mammogram,” he said. “Mammograms are still the right way to go, and that isn’t going to change.”
(Lee Chottiner can be reached at email@example.com.)