Knowing Your “Breast Density” Can Save Your Life (A Local Story)
Legislation: Breast Cancer and Breast Density
ROBERTSON COUNTY TENNESSEE: (Smokey Barn News) – As a surgeon, I see women with breast cancer. They are often surprised and hurt when they are told of the diagnosis. It is a difficult task. Physicians take courses on how to deliver such news to patients. I find that offering hope and a realistic but positive outlook is the best way to inform patients about such diagnosis.
Breast Cancer is the most common cancer among women. One in eight women are at a lifetime risk of developing breast cancer. It is a disease that spares no group or class. Nancy Reagan, Betty Ford, and Happy Rockefeller have suffered from it. So did my mom!
With tremendous advances in medical science, cure rates approach 100% with early diagnosis and treatment. Yes, early diagnosis is key. Cure rate for advanced breast cancer is as low as 20%. Early diagnosis saves lives! In order to discover breast cancer at an early stage, annual physical examination and breast x-ray, called mammography, are recommended for women over 40 or 50 years of age, depending on family history and risk factors. This is called a screening mammography.
Mrs. B had been concerned. Her mother had breast cancer. She knew that a positive family history increased her chances of developing breast cancer. She had regular yearly breast examinations and mammography. Last year, as always, she had her annual screening mammography. No cancer was found but the report mentioned that she had ‘dense breast tissue’. It also said that this type of tissue is ‘not abnormal’. Hidden in the complicated medical language, of the report, was the message that dense breast tissue can make it difficult for x-rays to see breast cancer. The recommendation for more tests (like ultrasound) was vague. Mrs. B and her nurse practitioner thought that things were fine since the mammogram did not find cancer.
Sadly, some months later, Mrs. B was found to have a large breast cancer. With good medical therapy and God’ grace, she is doing well and we pray for a successful outcome.
Mrs. B is a resident of Robertson County. She wrote to me about her breast cancer, not because I am a surgeon but because I am a State Representative. Her concern was that discovery of breast cancer may be delayed among other women who have dense breasts. One could not help but admire a lady like her! While fighting her own cancer battle, she was concerned about other women who might suffer.
I knew that women who have dense breast tissue, as seen on mammography, have increased risk of breast cancer and should be properly informed. A Tennessee law, passed in 2014, requires that these women receive a notice explaining the matter. The language of the notice, however, is confusing.
As your State Representative, I worked with Mrs. B and the Tennessee Radiological Society to develop new language for the ‘breast density letter’. I consulted with the legislators who had passed the previous law. Sen. Janice Bowling sponsored this legislation in the Senate. We wanted the letter to be clear, easy to understand and without medical jargon. Tennessee Radiological Society representatives, including the president, were most helpful. House Bill 2364 was passed into law and signed by Gov Bill Haslam on April 23, 2018 to become Public Chapter 750.
Every woman in the state of Tennessee, who is found to have dense breast tissue on mammography, will receive a notice stating that: “Your mammogram shows that you have dense breast tissue. Dense breast tissue is common. However, dense breast tissue can hide breast cancer, so that it may not be seen on routine mammography. 
It may also be associated with an increased risk of developing breast cancer. You should discuss these results with your doctor to determine if additional tests might be helpful. A report of your mammogram results, which contains information about your breast density, has been sent to your doctor’s office.
It is Mrs. B’s hope, and mine, that this notice will help towards early diagnosis of breast cancer and save lives. I am grateful that our system of government allows citizens to play a role in developing laws that help people like ourselves and solve problems. I feel Blessed to, personally, know Mrs. B and her family and their courage! Thanks be to God!
Sabi Doc Kumar MD is State Representative, District 66 – Robertson County. Reach him at [email protected].
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