Fall, 2013
ACR BI-RADS® The American College of Radiology’s BI-RADS® has long recommended the reporting of breast parenchymal composition as one of the components of the mammogram report, and describes the amount of tissue as one of four categories in the current edition BI-RADS® manual:
  1. The breast is almost entirely fat (<25% glandular).
  2. There are scattered fibroglandular densities (approx 25-50% glandular).
  3. The breast tissue is heterogeneously dense, which could obscure detection of small masses (approx 51-75% glandular).
  4. The breast tissue is extremely dense. This may lower the sensitivity of mammography (>75% glandular).
NC General Statute and January 1, 2014 More recently, however, legislators in many states have mandated that each patient be more fully informed of her individual breast density and its potential impact. North Carolina has joined nearly two dozen states on the list of states where radiologists are now or will soon be required by law to provide this information directly to the patient. Gov. McCrory signed the bill into law on July 23, 2013; after January 1, 2014 the following wording must be given to each patient with heterogeneously or extremely dense breasts:

“Your mammogram indicates that you may have dense breast tissue. Dense breast tissue is relatively common and is found in more than forty percent (40%) of women. The presence of dense tissue may make it more difficult to detect abnormalities in the breast and may be associated with an increased risk of breast cancer. We are providing this information to raise your awareness of this important factor and to encourage you to talk with your physician about this and other breast cancer risk factors. Together, you can decide which screening options are right for you. A report of your results was sent to your physician.”

What Now? North Carolina radiologists are collaborating to ensure a seamless transition and continued high quality care for our patients. The decision to pursue high risk screening breast ultrasound or breast MRI will be made on an individual patient basis. Both hand held and automated whole breast ultrasound exams are those being offered. The North Carolina ACR chapter is currently working with breast imagers from both academic and private practices to develop a NC website with easy access for referring providers and patients alike.

For More Info www.breastdensity.info We will keep you posted on the NC website progress!

Contributed by:
Sheryl G. Jordan MD, RCC 
Associate Professor of Radiology, Breast Imaging
University of North Carolina School of Medicine 
Chapel Hill, North Carolina
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