Do you have dense breasts?
Chances are you have no idea what those are, let alone whether or not you have them.
Well, that’s all going to change under Washington's new breast density notification law, which goes into effect on January 1, 2019.
Prior to the law, you’d get a mammogram and your radiologist would send the results to your doctor, which includes your breast density category, ranging from “mostly fatty” (nondense) to “extremely dense.” Your doctor would take that all into account and, depending on your medical history, might recommend additional breast cancer screening.
Under the new law, all of that still happens, but if you have dense breasts you’ll also get a letter directly from the radiologist, encouraging you to discuss things further with your doctor.
Advocates say the point is to give women more knowledge and power about their health — something that’s especially important in Washington, where we have some of the highest rates of breast cancer in the country.
“Radiologists are already reporting this information to doctors and clinics,” says Janie M. Lee, M.D., M.Sc., associate professor of radiology at University of Washington School of Medicine and director of breast imaging at Seattle Cancer Care Alliance. “The new law just requires that we communicate it directly to women, too.”
Laws like this have been passed in more than 30 states so far, but not everyone is on board.
The American College of Obstetricians and Gynecologists, for one, calls these laws problematic because they legislate medical practices. And the United States Preventive Task Force, a panel of clinical experts that reviews medical practices, does not recommend additional cancer screening for women with dense breasts.
So what’s the big deal with dense breasts? It’s all about what they may mean for you and your next mammogram.
What are dense breasts?
All breasts are made up of three different types of tissue, known by these decidedly unsexy names: fatty, fibrous and glandular.
Younger women tend to have more of the second and third kinds of breast tissue — that’s things like ducts, glands and connective tissues — but every woman has her own unique composition based on genes, hormones and a variety of other factors.
Breasts with mostly fatty tissue are what radiologists consider nondense, whereas breasts with higher concentrations of the other two tissues are categorized as dense.
“Breast density is entirely based on a mammogram. It’s a radiological finding and is not necessarily correlated on a physical exam,” explains Meghan Flanagan, M.D., M.P.H., a breast surgeon at Northwest Hospital & Medical Center and Seattle Cancer Care Alliance.