Relates to duties of providers of mammography services to notify and inform patients if a mammogram demonstrates dense breast tissue.
Ayes (59): Adams, Addabbo, Avella, Ball, Bonacic, Breslin, Carlucci, DeFrancisco, Diaz, Dilan, Duane, Farley, Flanagan, Fuschillo, Gallivan, Gianaris, Golden, Griffo, Grisanti, Hannon, Hassell-Thomps, Johnson, Kennedy, Klein, Krueger, Lanza, Larkin, LaValle, Libous, Little, Marcellino, Martins, Maziarz, McDonald, Montgomery, Nozzolio, O'Mara, Oppenheimer, Parker, Peralta, Perkins, Ranzenhofer, Ritchie, Rivera, Robach, Saland, Sampson, Savino, Serrano, Seward, Skelos, Smith, Squadron, Stavisky, Stewart-Cousin, Storobin, Valesky, Young, Zeldin
Excused (3): Alesi, Espaillat, Huntley
BILL NUMBER:S6769B REVISED 06/15/12
TITLE OF BILL: An act to amend the public health law, in relation to supplemental screenings
PURPOSE: This bill requires specific written notification to the patient of a finding of dense breast tissue on a mammogram, an explanation of what that means and a recommendation to consult with the patient's physician about additional screening.
SUMMARY OF PROVISIONS: Section one amends the public health law by adding a new section 2404-c which requires mammography providers to include the following notification in the summary of the mammography report provided to patients who have dense tissue as defined in the bill:
Your mammogram shows that your breast tissue is dense. Dense breast tissue is very common and is not abnormal. However, dense breast tissue can make it harder to find cancer on a mammogram and may also be associated with an increased risk of breast cancer.
This information about the result of your mammogram is given to you to raise your awareness. Use this information to talk to your doctor about your own risks for breast cancer. At that time, ask your doctor if more screening tests might be useful, based on your risk. A report of your results was sent to your physician.
Dense breast tissue shall mean heterogeneously or extremely dense tissue as defined in nationally recognized guidelines or systems for breast imaging reporting of mammography screening, including, but not limited to, the Breast Imaging Reporting and Data System (BIRADS) of the American College of Radiology, and any equivalent new terms, as such guidelines or systems are updated.
Section two sets forth the effective date as the one hundred eightieth day after it shall have become a law.
EXISTING LAW: There are no requirements in law for patients to be alerted to breast density.
JUSTIFICATION: One woman is diagnosed with breast cancer every three minutes, and one woman dies of breast cancer every 13 minutes in the United States. Cancer is four to six times more likely in women with dense breast tissue and 40% of women have dense tissue. According to a 2010 study published in the Annals of Surgical Oncology, 71% of all breast cancers occur in women with dense breast tissue. Mammograms fail to
detect about half the tumors present in dense breast tissue as dense tissue obscures the presence of the tumors. Follow-up studies after a similar dense breast tissue law passed in Connecticut in 2009 show that for women with dense tissue, the addition of a screening ultrasound nearly doubles the number of cancers found by mammography alone. In New York State, that number extrapolates to at least 2000 cancers a year in women who are told their mammogram results are "normal/negative," but who, in actuality, have invasive breast cancer. Missed cancers, growing undetected until at a later stage, are less treatable, least survivable and most expensive to treat.
Over 20 years ago, elected officials and medical experts reached a consensus that early breast cancer detection saved lives and states began requiring insurance coverage for mammograms. In order to ensure that patients received information about relevant mammographic findings, a federal law was enacted requiring a mammography report be issued to patients to help them partner with their physician in their health care vigilance.
A woman's breast density is determined through the mammography exam. Breast density not only dramatically compromises the effectiveness of a mammogram, but is, in and of itself, a risk factor for developing breast cancer. Women with dense breasts have a greater risk of developing breast cancer than those who have a first degree relative who have had the disease. Unfortunately, there is currently no protocol for density information to be shared with patients. The mammography reports to patients citing a "normal" finding - when the radiologist does not know, with any reasonable certainty what is lurking behind dense tissue - give women a false sense of security.
Now, twenty years later, states are recognizing that, for a significant percentage of women, the mammography notification requirements are not sufficient. The report a woman receives after her mammogram is required to be a summary, in lay language, of her mammographic findings. Information about breast density is a material medical finding which must be shared with patients. This legislation will give women with dense tissue the information to talk to their physician about getting adequate baseline and follow-up screening. Without it, women with dense tissue may be effectively denied equal access to early cancer detection without even knowing it.
LEGISLATIVE HISTORY: New bill.
FISCAL IMPLICATIONS: None.
EFFECTIVE DATE: This bill takes effect on the one hundred eightieth day after it shall have become a law.
STATE OF NEW YORK ________________________________________________________________________ 6769--B IN SENATE March 20, 2012 ___________Introduced by Sens. FLANAGAN, ALESI, BALL, GOLDEN, GRISANTI, HUNTLEY, JOHNSON, LAVALLE, OPPENHEIMER, PARKER, PERKINS, RITCHIE, STAVISKY, STEWART-COUSINS -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the public health law, in relation to supplemental screenings THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The public health law is amended by adding a new section 2404-c to read as follows: S 2404-C. BREAST CANCER; DUTY OF PROVIDERS OF MAMMOGRAPHY SERVICES TO NOTIFY AND INFORM. EVERY PROVIDER OF MAMMOGRAPHY SERVICES SHALL, IF A PATIENT'S MAMMOGRAM DEMONSTRATES DENSE BREAST TISSUE, PROVIDE NOTIFICA- TION TO SUCH PATIENT THAT SHALL INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING INFORMATION, IN ANY SUMMARY OF THE MAMMOGRAPHY REPORT SENT, PURSUANT TO THE FEDERAL MAMMOGRAPHY QUALITY STANDARDS ACT, TO THE PATIENT: YOUR MAMMOGRAM SHOWS THAT YOUR BREAST TISSUE IS DENSE. DENSE BREAST TISSUE IS VERY COMMON AND IS NOT ABNORMAL. HOWEVER, DENSE BREAST TISSUE CAN MAKE IT HARDER TO FIND CANCER ON A MAMMOGRAM AND MAY ALSO BE ASSOCI- ATED WITH AN INCREASED RISK OF BREAST CANCER. THIS INFORMATION ABOUT THE RESULT OF YOUR MAMMOGRAM IS GIVEN TO YOU TO RAISE YOUR AWARENESS. USE THIS INFORMATION TO TALK TO YOUR DOCTOR ABOUT YOUR OWN RISKS FOR BREAST CANCER. AT THAT TIME, ASK YOUR DOCTOR IF MORE SCREENING TESTS MIGHT BE USEFUL, BASED ON YOUR RISK. A REPORT OF YOUR RESULTS WAS SENT TO YOUR PHYSICIAN. FOR THE PURPOSES OF THIS SECTION DENSE BREAST TISSUE SHALL MEAN HETER- OGENEOUSLY DENSE OR EXTREMELY DENSE TISSUE AS DEFINED IN NATIONALLY RECOGNIZED GUIDELINES OR SYSTEMS FOR BREAST IMAGING REPORTING OF MAMMOG- RAPHY SCREENING, INCLUDING, BUT NOT LIMITED TO, THE BREAST IMAGINGEXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD15074-11-2 S. 6769--B 2
REPORTING AND DATA SYSTEM OF THE AMERICAN COLLEGE OF RADIOLOGY, AND ANY EQUIVALENT NEW TERMS, AS SUCH GUIDELINES OR SYSTEMS ARE UPDATED. S 2. This act shall take effect on the one hundred eightieth day after it shall have become a law.