Impact of Breast Density Legislation on Breast Cancer Risk Assessment and Supplemental Screening: A Survey of 110 Radiology Facilities.
Breast density notification laws, passed in 19 states as of October 2014, mandate that patients be informed of their breast density. The purpose of this study is to assess the impact of this legislation on radiology practices, including performance of breast cancer risk assessment and supplemental screening studies. A 20-question anonymous web-based survey was emailed to radiologists in the Society of Breast Imaging between August 2013 and March 2014. Statistical analysis was performed using Fisher's exact test. Around 121 radiologists from 110 facilities in 34 USA states and 1 Canadian site responded. About 50% (55/110) of facilities had breast density legislation, 36% of facilities (39/109) performed breast cancer risk assessment (one facility did not respond). Risk assessment was performed as a new task in response to density legislation in 40% (6/15) of facilities in states with notification laws. However, there was no significant difference in performing risk assessment between facilities in states with a law and those without (p < 0.831). In anticipation of breast density legislation, 33% (16/48), 6% (3/48), and 6% (3/48) of facilities in states with laws implemented handheld whole breast ultrasound (WBUS), automated WBUS, and tomosynthesis, respectively. The ratio of facilities offering handheld WBUS was significantly higher in states with a law than in states without (p < 0.001). In response to breast density legislation, more than 33% of facilities are offering supplemental screening with WBUS and tomosynthesis, and many are performing formal risk assessment for determining patient management.
Stanford University, Stanford, California.
Lina
L
Nayak
Stanford University, Stanford, California.
Kanae K
KK
Miyake
California Pacific Medical Center, San Francisco, California.
Jessica W T
JW
Leung
University of California San Francisco, San Francisco, California.
Elissa R
ER
Price
Stanford University, Stanford, California.
Yueyi I
YI
Liu
University of California San Francisco, San Francisco, California.
Bonnie N
BN
Joe
University of California San Francisco, San Francisco, California.
Edward A
EA
Sickles
Stanford University, Stanford, California.
William R
WR
Thomas
Stanford University, Stanford, California.
Jafi A
JA
Lipson
Stanford University, Stanford, California.
Bruce L
BL
Daniel
University of California Davis, Davis, California.
Jonathan
J
Hargreaves
Alta Bates Summit Medical Center, Berkeley, California.|University of California San Diego, San Diego, California.
R James
RJ
Brenner
University of California Los Angeles, Los Angeles, California.
Lawrence W
LW
Bassett
University of California San Diego, San Diego, California.
Haydee
H
Ojeda-Fournier
University of California Davis, Davis, California.
Karen K
KK
Lindfors
University of California Irvine, Irvine, California.
Stephen A
SA
Feig
Stanford University, Stanford, California.
Debra M
DM
Ikeda
D000071060:Breast Density; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002170:Canada; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008327:Mammography / Q000706:statistics & numerical data; D011871:Radiology / Q000331:legislation & jurisprudence* / Q000379:methods; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016217:Ultrasonography, Mammary / Q000706:statistics & numerical data; D014481:United States
breast cancer screening; breast density legislation; breast density notification laws