2019 Brings Dense Breast Legislation on State and Federal Level to Improve Breast Cancer Screening Services, Fulfilling Nancy Cappello’s Legacy

By Nov 18, 2019 News

Better screening has led to earlier detection and better survival rates for breast cancer patients in the last decades. But one group of women has not benefited as much: women with dense breast tissue. Dense breast tissue is one of the most common reasons for failure of mammography to detect cancer, presenting significant challenges for both breast cancer patients and providers. Despite being a well-established independent risk factor for breast cancer, studies suggest that only about 36% of women have been informed of their breast density and many women with dense breasts don’t learn they have breast cancer until their disease has already reached an advanced stage. It is important to diagnose breast cancer as early as possible, as the 5-year survival rate is 99% when diagnosed in the early stages, and decreases as a diagnosis comes at more advanced stages. 

“The problem is that a mammogram renders dense breast tissue as white, but a cancerous tumor can also appear as a single white blob,” Dr. Erica Giblin explained in her surgeon spotlight. “So you’re viewing white over white. There’s a common expression in radiology that trying to find cancer amid dense breast tissue is like trying to find a polar bear in a snowstorm.” 

In 2018, Dune Medical teamed up with Margie Singleton and AreYouDense? Advocacy to help raise awareness of the potential risk dense breast tissue presents for the diagnosis and treatment of breast cancer. Dune Medical Devices CEO Lori Chmura, Margie Singleton, and the late Dr. Nancy Cappello met with previous Georgia Governor Nathan Deal and Congresswoman Sharon Cooper to plead for legislation in Georgia. On May 2, 2019, new Georgia Governor Brian Kemp signed dense breast legislation, appropriately named “Margie’s Law”, into law. The new legislation will require all mammogram reports in the state of Georgia to inform women that they have dense breast tissue and what the implications of this finding may mean for them. With this information, in conjunction with their healthcare provider and other risk factors, they may want to pursue further testing and screening, such as ultrasound or MRI. 

Since then, on a federal level, the U.S. Food and Drug Administration (FDA) proposed similar amendments to improve the quality of mammography services and allowing for more informed medical decision-making. This is the first time that the FDA has proposed amendments to improve mammography services in over 20 years of regulating mammography facilities as part of the Mammography Quality Standards Act of 1992

The amendments mark a critical milestone in modern mammography with the addition of breast density notification in the summary letter provided to patients who receive a mammogram and to the medical report provided to their referring healthcare professional. The FDA is proposing specific language that would explain how breast density can influence the accuracy of mammography and would recommend patients with dense breasts talk to their healthcare provider about high breast density, how it relates to breast cancer risk and their individual situation. 

Dr. Nancy Cappello, image courtesy of AreYouDense.org

It has now been one year since Nancy Cappello passed away due to complications from prior cancer treatments. On the anniversary of Nancy’s untimely death, we want to dedicate the recent legislative successes to the late Nancy Cappello, who started the dense breast legislation movement in 2004 after her tumor was missed in mammograms several times because she had dense breast tissue. Dune is a proud supporter of these and other efforts to improve breast cancer screening and care for better outcomes. 

You can learn more about dense breast tissue and the possible mammogram screening options by visiting https://www.areyoudense.org/ and read the story of Margie Singleton how championed the Georgia Dense Breast Legislation here.