Courtesy Gunnison Country Times, October 6, 2016
Law would mandate reporting of density
Times Staff Writer
For some women, an annual screening for breast cancer may not be enough to catch the disease in its early stages. Since early detection can be critical to a patient’s outcome, a Gunnison doctor is pursuing legislation that requires caregivers to notify their patients of a particular risk — one that may impact a large percentage of women in the Gunnison Valley than is the case nationally.
The measure if passed would mandate breast density “scores” be reported to patients following mammograms. Two previous attempts to pass similar bills have failed.
“We just want patients to be notified,” said Stephania Timothy, a general surgery specialist at Gunnison Valley Hospital. “A lot of the women who have been surprised have been the ones who have had a mammogram, have gotten a letter (indicating no problems) and a month later they get a lump.”
Are you dense?
Dense breast tissue is comprised of less fat and more connective tissue which appears white on a mammogram. It’s estimated about 40 percent of women have dense tissue, and Timothy said the percentage may be even higher in the Gunnison Valley.
According to densebreastinfo.org, an educational information organization with contributing physicians, a woman’s risk of breast cancer increases with the density of her tissue, and younger, healthier women have an increased likelihood of dense issue.
Further, detection is made more difficult because of the condition — cancer also appears white on mammograms and thus tumors can often be hidden or masked by the dense tissue.
Some women with dense tissue have reported having normal yearly screenings, only to discover a short time later they have cancer.
The proposed measure would dictate that women would be notified following a mammogram if their breast density is high and directed to discuss alternative screening with their physician.
Twenty-eight states currently mandate health care providers to notify women of their density score following annual screenings.
Three states suggest notification be conducted. Five states are considering such legislation while Colorado is one of five states with measures labeled “inactive.” The remaining nine states do not have notification legislation proposed.
Finding support a challenge
Timothy is attempting to secure a sponsor in the state Senate for the bill — the Senate is where two previous measures failed. Opponents of the bill say it is “not good medicine.”
In an e-mail to the Times, a doctor with Colorado Permanente Medical Group wrote that notification would not increase earlier detection of breast cancer or save lives.
“This would increase anxiety in women with no good follow up imaging of breasts,” wrote Kim Warner who works with governmental relations for the medical group and is on the Board of Directors for the Colorado Medical Society.
Yet, Timothy is pressing forward, assisted by a breast cancer survivor, Lori Gallagos of Aurora.
Gallagos said her own cancer was not detected by a mammogram because she has dense tissue.
Letters, Gallegos said, have been sent to about 17 state senators, yet only two have responded. One indicated she is not interested in carrying the legislation. Another, she said, indicated she will consider the request. Timothy and Gallegos both indicated finding a sponsor has been difficult while the legislature is in recess.
Sen. Kerry Donovan, who Timothy said she has contacted, told the Times she is still researching the legislation, its history and its merits.
In the meantime, Timothy is educating local health care providers and patients of the importance of knowing their density score. She is also working with Gunnison Valley Hospital to purchase equipment that can aid women with dense breasts receive proper screening and cancer detection.
“Breast density is more associated with women who have a lower body fat index and that’s obviously our valley,” said Timothy. “I think it’s something important that we need to get out there.”
(Chris Rourke can be contacted at 970.641.1414 or at firstname.lastname@example.org.)