NEW! Now that the FDA dense breast reporting standard is in effect, DBI has retired its “State Inform Law Map” (however, the map is still available upon request).
As the next focus is insurance coverage for supplemental screening, DBI has launched a new interactive State Law Insurance Map. The map tracks breast imaging insurance coverage by state, and a corresponding State Law Insurance Table is also available.
Visit the ”Insurance/Inform Laws” tab for individual links to:
2024 Success Story
New York State Insurance Law
New York has amended its breast imaging insurance law to require certain insurance policies to allow patients additional screenings for breast cancer when the provider deems such screening is necessary under nationally recognized clinical practice guidelines. Please see DBI’s Insurance/Inform Laws tab for more details.
State Insurance Law
Alaska is the latest state to enact a law that requires insurers to cover expanded breast imaging. Visit the DBI Insurance/Inform Laws tab for updated maps and new insurance table.
National Density Inform Standard (finally)
On Tuesday, September 10, the FDA’s requirement to provide patients with one of two standardized letters (“dense” or “not dense”) after their mammograms goes into effect. More information, including how to contact the FDA with questions, is available HERE.
FDA Reporting Standard
We are 10 days away from the FDA’s effective date for mandatory density reporting to both patients and referring providers. Please visit DBI’s FDA page which now includes a link to an FDA Compliance Guide (with helpful Q+As). DBI public comments on the September 10th effective date are available HERE.
New European Education Supporter, Albania
We welcome, Iris Allajbeu, MD, PhD, FRCR to the DBI/Europe team! Dr. Allajbeu is Associate Professor of Radiology, Western Balkans University, Tirana, as well as honorary consultant radiologist for the American Hospital in Tirana, International Advisory Board for the Western Balkans University, honorary clinical lecturer and co-lead of Clinical Research, President of ALSOBI and Vice President of the AAR. She is also Senior Clinical Research Associate, Honorary Consultant, Department of Radiology, University of Cambridge Addenbrooke’s Hospital, Cambridge, UK.
Study: Geographic Accessibility
Christensen et al. considered access to MRI and mammography by examining zip codes and a mapping tool that displays the relative socioeconomic conditions of neighborhoods. The study found the average distance to access breast MRI was 23 miles, 22 miles for breast ultrasound, and only 8 miles for mammography.
State Insurance Law Amendment
Illinois has amended its insurance law for expanded breast imaging. MBI will now be included (effective 1/1/26), please see DBI’s legislation MAP for details.
Research Analysis
An analysis of “real-world” experience with supplemental abbreviated MRI (AB-MRI) screening in women with dense breasts and average breast cancer risk was conducted by senior author and DBI Advisory Board Member Emily Conant, MD and colleagues. The cancer detection rate for baseline AB-MRI exams was higher than for subsequent exams, however the difference was not significant. [1]
1. The cancer detection rate for baseline vs. subsequent AB-MRI exams was 18.9 per 1000 (38/2007) vs. 12.1per 1000 (7/278) respectively (P=.37).
2. The false positive rate decreased from 7.7% (116/1497) for baseline exams to 2.8% (10/359) for subsequent exams (P<.001).
State Insurance Laws
NEWS on insurance laws for expanded breast imaging in Louisiana, Mississippi, New Hampshire, and Nevada. Currently, 32 states + DC have insurance laws for expanded coverage for either screening or diagnostic imaging. Alaska may be next – that bill is on the governor’s desk – stay tuned!
Rhode Island Density Inform Law Amended
In preparation for the FDA’s new dense breast reporting standard going into effect Sept 10, 2024, Rhode Island has amended its existing “inform” law. The Rhode Island inform law will now defer to the FDA’s national reporting standard. Please see DBI’s State Law Map or Table for details. As previously mentioned, existing state density inform laws may remain in effect in addition to the FDA requirement unless that state law specifically defaults to the new FDA standard, expires, or is repealed.
Just Published
A retrospective study just out in Radiology, Comparison of Mammography and Mammography with Supplemental Whole-Breast US Tomography for Cancer Detection in Patients with Dense Breasts, evaluated the performance of US tomography (UST) combined with full-field digital mammography (FFDM) in a reader study in women with dense breasts. The addition of UST improved cancer detection over FFDM alone and the detection rate was comparable to other ultrasound screening methods.
USPSTF Guidelines / Editorial by Dr. Wendie Berg
The United States Preventative Services Task Force (USPSTF) has released a Task Force Recommendation Statement for breast screening. DBI’s Chief Scientific Advisor, Dr Wendie Berg, was invited to respond in an editorial on the key advances and opportunities to enhance breast screening guidelines moving forward: USPSTF Breast Cancer Screening Guidelines Do Not Go Far Enough. [See DBI announcement for a summary of details.]
U.S. State Insurance Laws
Two new states, Iowa and Vermont, have enacted insurance laws for expanded breast imaging coverage after a mammogram.
The World’s Leading Resource on Dense Breasts, Now Leads the Fight for the Find It Early Act
DBI had a full schedule on Capitol Hill last week meeting with key Congressional members. The federal bill would ensure all health insurance plans cover screening and diagnostic imaging with no out-of-pocket costs for women with dense breasts or higher risk for breast cancer. WE NEED YOU TO TAKE ACTION. Please share your perspective/examples of denials for coverage for supplemental imaging, resulting delayed screening, unexpected insurance costs, etc., with your congressperson. FYI, congressional members have made it clear that personal direct reach outs are much more effective than petitions. Please contact your congressperson and ask for them to support the bill, learn how HERE.
Patient Density Request Forms
Women out of the U.S. have asked for a resource to request their breast density after their mammograms. DBI features 5 versions of a Patient Density Request Form for specific health systems, the newest version in Arabic.
Density Request forms are available as free downloads:
New U.S. State Insurance Law
The state of Kentucky becomes the 28th state to enact a law requiring some level of insurance coverage for additional breast imaging after a mammogram.
New Study
Just out in Radiology, study Use of an AI Score Combining Cancer Signs, Masking, and Risk to Select Patients for Supplemental Breast Cancer Screening. This large retrospective study found that an AI-based risk model incorporating cancer signs, masking and risk was superior to breast density alone in identifying patients with a negative screening mammogram who were likely to develop subsequent breast cancer. The AI-based risk model, known as AISmartDensity, identified 33% of future cancers compared to 13% for the density-based model.
U.S. State Inform Law
Better late than never! Indiana has enacted a breast density inform law (effective July 1, 2024) which mirrors the new FDA required “dense breast” reporting language (effective Sept 10, 2024). This brings the number of states with inform laws to 39 and the District of Columbia. Please see DBI’s legislation MAP or TABLE for more details.
European Congress of Radiology – Highlight
Congratulations to Prof. Boris Brkljačić, Chair of the EuroSafe Imaging Steering Committee and DenseBreast-info.org/Europe Education Supporter! Prof. Brkljačić was awarded the ESR Gold Medal, the highest honour bestowed by the society, at the ECR 2024 Opening Ceremony.
U.S. State Insurance Bill Update
Massachusetts has become the latest state to introduce an insurance bill for expanded breast imaging beyond a mammogram.
State “Inform” Laws and the FDA Reporting Standard
We have received questions about existing state dense breast inform laws and the imminent FDA dense breast reporting standard. It is important to note that existing state density inform laws may remain in effect in addition to the FDA requirement unless that state law specifically defaults to the new FDA standard, expires, or is repealed. FDA guidance is that mammography facilities should be aware of and comply with all applicable local, state, and federal “dense breast” reporting requirements. More information, including how to contact the FDA with questions, is available here.
U.S. Insurance bills
New insurance bills for coverage of expanded breast imaging have been introduced in the states of Iowa and Oklahoma.
SBI Newsletter
SBI’s Winter 2024 newsletter includes an interview with DBI’s JoAnn Pushkin, in The Patient’s Perspective column, about the patient dense breast experience, advocacy efforts and next steps on the legislative front.
DBI developed a Statement of Support for this important legislation and worked to get American Alliances, Associations, Colleges, Institutions, Cancer Centers, Imaging Centers, Societies, and Foundations to add their names. Over 40 fellow organizations did so. The bill sponsors, Representatives Rosa DeLauro (D-CT) and Brian Fitzpatrick (R-PA), plan to share this statement with congressional leadership.
The Statement of Support complements other DBI tools created to support the Find It Early Act:
DBI has been at the forefront of efforts for both a U.S. national density reporting standard and for legislation that ensures expanded insurance coverage of breast imaging. We extend thanks to all who support our Education Coalition!
U.S. State Insurance Bill
The state of Illinois has introduced insurance bill HB4180 for expanded mammography coverage and expanded supplemental screening (for no-cost MBI or MRI). For information about IL’s existing insurance laws, please visit DBI’s legislation MAP.
Health Provider FAQs
Did you know? The DenseBreast-info.org website features 50+ health provider FAQs, and answers include relevant research citations.
U.S. Insurance Bill
Michigan has introduced bill HB5084 for expanded insurance coverage of screening and diagnostic breast imaging. For state-by-state information about inform and insurance laws, visit DBI’s legislation MAP.
Canadian Provincial Bill
The province of Nova Scotia has introduced Bill 356 that calls for women with dense breasts to have supplemental cancer screening such as an ultrasound or magnetic resonance imaging (MRI). For info by Canadian province on density “inform” and supplemental screening programs, please visit DenseBreastsCanada.
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