• Quote: Supplemental breast cancer screening for dense breast tissue

    Laws in about a dozen states that require radiologists to notify patients if they have dense breast tissue have raised questions about the utilization of new supplemental screening techniques for breast density and how radiologists identify density levels.

    – Jaimy Lee, Modern Healthcare

    As it turns out, the Comparative Effectiveness Public Advisory Council, of which I am a member, will be discussing this very issue at our next meeting on December 13 in Boston. It’s open to the public. Details here.


    • I read the report. There is no clearcut winning strategy for screening that emerges. The conventional methods for screening reduce breast cancer deaths by 20-25%. Improvements are incremental in impact with more imaging such as MRI and ultrasound, but each produces real increases in cost and procedures on women who are not carrying deadly cancers.
      I know that it is stating the obvious to say that we need more quality data to help us choose the right path.
      I noted that most of the states mandating the report of “dense breasts” which I believe will be taken as grim news by the patients are in New England. Is there the political will to form a consortium to study this issue? Perhaps one could mandate a three dollar surcharge with one dollar going for outcome studies in the dense population, one going to research for new screening modalities, and one for outreach to underscreened populations.
      When I read German studies on Hodgkin disease, I am always struck that 95% of their patients are in clinical studies. Can we seize this chance to make a better program for this disease?

    • I will be very interested in your report on this meeting. I am in one of those states — Indiana — and it has been both challenging and time consuming to explain the density rule and what to do next to patients, who often don’t understand the difference between screening and diagnostic testing to begin with! Thanks for doing the important work of slogging through studies, wrangling policies and generally clearing the path for those of us in the trenches.

    • I guess the obvious question is why are politicians micromanaging the practice of medicine?
      – Have doctors failed to do it right? (Possibly)
      – Are they responding to special interests? (“victims” or people who stand to make money from the extra testing)… (Probably)
      – Because they can?