Mammograms might not detect cancer in dense breasts

From: http://blog.sfgate.com/chronrx/2013/04/03/are-you-dense/    By: Victoria Colliver

California’s new breast density notification law, which went into effect on Monday, may not have happened had it not been for Amy Colton’s outrage. After the labor and delivery nurse from Santa Cruz was diagnosed with breast cancer, she learned that she was never told what her doctors already knew — that the type of breast tissue she had allowed her cancer to go undetected in her annual mammograms. About 40 percent of women have dense breast tissue, but most don’t know it. So Colton set out to change that.

She teamed with with former state Sen. Joe Simitian, D-Palo Alto, to pass legislation that would require women to be told if they have the type of breast tissue that could make mammography an ineffective screening tool. The bill didn’t get the governor’s signature on the first try, but it did on the second attempt last year. For more about the new notification law, go here.

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My commentary:

This implies that up to 40% (almost half!) of all mammograms are being inflicted upon women who might have no benefit from them!

Is it really too much to ask that a doctor tell you the implications of a screening tool that doesn’t work reliably on your body?   Is there so much resistance to sharing this information with patients that it has to be legislated?

Dense breast tissue is obvious in a mammogram, so the radiologist always knows. Does this information ever reach the patient? Does it get mentioned along with the warning that her mammograms will probably never detect cancer? Or has this inconvenient fact been so well papered over in the media that doctors don’t even know?

Mammogram facilities have become a hugely lucrative business under our current health care system, and are often run as such, with profit as the primary motive. I’m sure they would be reluctant to reveal these facts to patients who are almost guaranteed to “buy” 50 mammograms over their lifetimes, thanks to constant pressure from “healthcare providers” and the media.

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