Dense Breast Notification Laws: Impact on Downstream Imaging After Screening Mammography

Dense breast tissue is a common finding that decreases the sensitivity of mammography in detecting cancer. Many states have recently enacted dense breast notification (DBN) laws to provide patients with information to help them make better-informed decisions about their health. To test whether DBN l...

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Bibliographic Details
Published in:Medical care research and review 2020-04, Vol.77 (2), p.143-154
Main Authors: Horný, Michal, Cohen, Alan B., Duszak, Richard, Christiansen, Cindy L., Shwartz, Michael, Burgess, James F.
Format: Article
Language:English
Subjects:
Adult
Breast
Breast cancer
Breast Density
Breast Neoplasms - diagnostic imaging
Disclosure
Early Detection of Cancer
Female
Health insurance
Humans
Legislation
Magnetic resonance imaging
Mammography
Mammography - standards
Mass Screening
Medical imaging
Middle Aged
Notification
Ultrasonic imaging
Ultrasonography
Ultrasound
United States
Women
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Summary:Dense breast tissue is a common finding that decreases the sensitivity of mammography in detecting cancer. Many states have recently enacted dense breast notification (DBN) laws to provide patients with information to help them make better-informed decisions about their health. To test whether DBN legislation affected the probability of screening mammography follow-up by ultrasound and magnetic resonance imaging (MRI), we examined the proportion of times screening mammography was followed by ultrasound or MRI for a series of months pre- and post-legislation. The subjects were women aged 40 to 64 years, covered by private health insurance, undergoing screening mammography from 2007 to 2014. Except for Hawaii, Maryland, and New York, DBN legislation significantly increased the probability of ultrasound follow-up in all states that implemented DBN legislation before December 2014. It also increased the probability of MRI follow-up in California, North Carolina, Pennsylvania, and Texas. The financial and access consequences merit further study.
ISSN:1077-5587
1552-6801
DOI:10.1177/1077558717751941