State Laws Guarantee More Information for Breast Cancer Patients

Two states have enacted laws that require physicians to better communicate breast health information.

The Connecticut General Assembly enacted a 2009 law that requires insurance companies to cover an ultrasound if a woman is deemed to have dense breast tissue. Furthermore, women must be informed of their breast density when they receive their mammography reports. Denser breast tissue typically signifies more glandular and connective tissue and less fatty tissue. A number of other states, including Texas and New York, are considering similar legislation.

So why the concern about breast density? Both connective tissue and tumors appear white on a traditional mammography image, and therefore, can look the same even to a trained eye. Also, women with very dense breasts have a breast cancer risk four to six times higher than those with less dense breasts, according to studies published in The New England Journal of Medicine and Cancer.

New York has also taken measures to increase breast health communication. As of Aug. 15, state law now requires hospitals and doctors to discuss breast reconstruction options, insurance coverage and referral to another hospital for the reconstructive surgery (if necessary)—all before breast cancer surgery.

Congress passed the Women’s Health and Cancer Rights Act in 1998, which guarantees coverage for women who elect reconstructive surgery following a mastectomy or lumpectomy. However, only 30 to 40 percent of women who undergo mastectomy elect to have reconstructive surgery, according to Evan Garfein, MD, a plastic surgeon at Montefiore Medical Center, who authored the bill.

The new law targets women who are unaware of their options, are not offered reconstructive surgery as an option by their doctors or who are unsure if their insurance will cover the procedure.