An Expert Discusses Breast Density Notification Laws

An Appropriate Topic for Legislation?

Medscape: I've got a larger question here; it's the idea about legislators getting involved in patient care decisions in this way. You have a fairly broad experience in radiology. Could you see this extending into other areas as well?

Dr. Monticciolo: Again, my main concern is unintended consequences. Many things sound great in theory, until you start working on the details and looking at the data critically. New ideas are often accepted enthusiastically because we all want to do better for our patients. We want to diagnose more cancers earlier, but we should approach these things with caution or we're going to end up unsatisfied. That is my concern. There are many questions around this topic, such as how to consistently and accurately assign breast density in the first place, and yet we have a law. It may be well intended, but it's premature.

I think that it's possible that we'll see this extend to other areas, but if it does, I hope there are lessons taken from this experience. I would hope that more data and more thought are put in up front, so that the legislation will be streamlined to do just what it needs to do and not more. Understanding the legislative process is never easy. What grabs the attention of politicians is not always obvious to me.

Medscape: What is your advice to breast imagers in other states where this issue has or will come up?

Dr. Monticciolo: I would say that breast imagers and patients should work together for reasonable solutions that can be supported by real data. I would like to think that lawmakers will allow time for this to happen, and not respond to pressures from those who are simply promoting their own technology or their own agendas.

I think if we stick to science and keep a dialogue open and are responsive to our patients, then we can make progress in the fight against breast cancer. After all, we are on the same side. So my advice is to work together for solutions.