This week, New Jersey became the 14 ^thstate to require mammography reports to include information for patients on breast density status and its implications on the risk of developing breast cancer.

The New Jersey bill also requires insurers to cover additional testing in certain medically necessary circumstances.

Concerns were raised by legislators that the bill would intrude on the doctor-patient relationship, and the New Jersey section of the American Congress of Obstetricians and Gynecologists worried the law would result in additional unnecessary testing. Ultimately, legislators and Gov. Chris Christie found merit in ensuring information on this important and complex topic is disseminated to patients.

Patient advocacy group D.E.N.S.E. (Density Education National Survivors’ Effort), a grassroots advocacy outgrowth of Are You Dense, Inc., hailed the bill’s signing as a success, noting that almost half of the women in the U.S. now live in a state that requires breast density notification. Following the first such law in Connecticut, laws spread to Alabama, California, Hawaii, Maryland, Nevada, New York, North Carolina, Oregon, Pennsylvania, Tennessee, Texas and Virginia.

So where will the next domino fall in what seems like an inevitable spread of density notification legislation? According to Are You Dense, bills have already been introduced in Indiana, Iowa, Massachusetts, Michigan, Missouri, Ohio and Washington, with legislators in another nine states currently working on drafting a bill.

But the ultimate victory for breast density notification advocates would be a national standard, which could come either through legislation or regulation. The federal Breast Density and Mammography Reporting Act of 2013, or HR 3404, was introduced by Reps. Rosa DeLauro (D-Conn.) and Steve Israel (D-NY), and has 29 co-sponsors. It was referred to the House Committee on Energy and Commerce last fall. Like the state laws that have popped up in recent years, HR 3404 would require notification of breast density status on mammography reports as well as language urging patients to consult with their physicians about whether any supplemental screening is warranted. On the federal regulatory front, a Breast Density Reporting amendment to the Mammography Quality Standards Act (MQSA) is scheduled to be issued as a "Notice of Proposed Rulemaking" in 2014, according to JoAnn Pushkin, co-founder of D.E.N.S.E.

What are your thoughts on the spread of breast density notification laws? If you work in a state that has already passed such a law, how has it affected your practice? We’d love to hear from you.

Evan Godt 
Editor – Health Imaging

egodt@trimedmedia.com