News Room: SB 173: Comprehensive Breast Tissue Screening

Gov. Jerry Brown probably made more good than bad decisions on various bills this fall. But it was infuriating to see him veto Sen. Joe Simitian’s bill requiring full disclosure to women whose mammograms may be ineffective.

It was so simple, so certain to save lives that we could not imagine a veto. But the medical establishment pulled out all the stops to kill it.

Amy Colton persuaded Simitian to carry the bill after she was diagnosed with advanced breast cancer despite years of supposedly clear mammograms. She learned, too late, that her dense breast tissue obscured the cancer. This condition is noted in reports to doctors but not in reports sent to patients, who develop a false sense of security.

In his veto statement, Brown said women should have the information, but he objected to the notification suggesting women talk to their physicians about further screening. Good grief. If women learn mammograms aren’t effective for them, they’d be crazy not to ask about alternatives.

When the Legislature reconvenes, Simitian should resubmit the bill minus the offending suggestion to consult doctors. The original bill got broad bipartisan support. In the meantime, Colton and Simitian may have saved lives just by airing the issue: All women should ask their doctors about dense breast tissue. And—sorry, governor—about alternative screening.

 

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Governor Jerry Brown has vetoed State Senator Joe Simitian’s (D-Palo Alto) bill to improve breast cancer detection, notwithstanding the bill’s broad bipartisan support (35-1 in the Senate, 66-6 in the Assembly). Senate Bill 791 required that following a mammogram, women with dense breast tissue be informed that: they have dense breast tissue; that dense breast tissue can obscure abnormalities (i.e., cancer) on a mammogram; and that they may wish to discuss the potential value of additional screening(s) with their doctors. read more ...

No, Sen. Joe Simitian isn't even thinking about trying to override Gov. Jerry Brown's veto of his bill that would have required doctors to inform women with high breast density that they have the condition -- which can mask tumors during mammograms. read more ...

State Senator Joe Simitian’s (D-Palo Alto) bill to improve breast cancer detection has passed the State Legislature and now goes to the Governor for consideration. Senate Bill 791 requires that following a mammogram, patients with dense breast tissue be informed that they have dense breast tissue, that dense breast tissue can obscure abnormalities (i.e., cancer) on a mammogram and that they may wish to discuss the potential value of additional screening(s) with their doctors. read more ...

For seven straight years since turning 40, Amy Colton religiously scheduled a mammogram. Every year, the test showed nothing.

Two years ago, however, the registered nurse was shocked to discover she was in the latter stages of breast cancer. Then she learned that her radiologist and primary-care physician knew she had a condition that blocks the detection of cancer cells in mammograms—but they never told her.

Now she’s even more shocked that California’s powerful medical lobby is trying to block legislation that would require physicians to tell women if they have the condition, known as “extremely dense breast tissue.”

“I’m the patient; it’s my body. But I was never informed,” said Colton, who lives in Soquel. “It just took my breath away.”

Colton took her complaint to Sen. Joe Simitian, D-Palo Alto, who introduced SB 173, which would require doctors to tell women if they have the condition.

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Mammograms should be recommended to women based on several individual risk factors, such as age, family history and breast density, doctors said in a study published Monday in the Annals of Internal Medicine.

But how many women know their breast density?

Under legislation proposed in California, every woman who has a mammogram would also receive information on her breast density. Studies have confirmed that having more high-density tissue, which has less fat, raises breast cancer risk while having more low-density tissue lowers it.

The proposed legislation, Senate Bill 173, is opposed by several medical groups, however. In a recent statement, the American Congress of Obstetricians and Gynecologists of District IX, the California Radiological Society, the California Medical Assn. and other groups say they oppose the bill.

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There’s one thing worse than a medical report that says you have cancer. That’s a report that says everything’s peachy keen—even though the procedure couldn’t really tell.

Soquel resident Amy Colton got caught in this trap. Despite annual all-clear mammograms, she suddenly found she had advanced breast cancer. Only then did she learn that she is among millions of women whose tissue is too dense for a mammogram to detect a small tumor.

And she’s a registered nurse.

Colton won state Sen. Joe Simitian’s “There Oughta Be a Law” contest, and he introduced SB 173 to require that patients be told if they have dense tissue. Then, they and their doctors—who already get this information routinely—can decide whether to have further screening.

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State Senator Joe Simitian (D-Palo Alto) will be joined by breast cancer survivor and “ARE YOU DENSE?” founder, Nancy Cappello, PhD and radiologist Dr. Judy Dean at a press conference to discuss Senate Bill 173 and the importance of a patient’s right to knowledge about breast density. read more ...

Cancer. No matter how sensitively the diagnosis is delivered, it is baffling, angering and frightening. Especially when you think you’ve done everything right to help ward off such a devastating diagnosis.

As a nurse, I’m diligent about my health. I get annual mammograms, perform self-exams, eat a healthy diet, exercise daily and have no family history of cancer. I thought I was armed with the information I needed to take care of my own well-being. I was wrong.

The missing piece of the puzzle turns out to be a piece of information that shouldn’t have been missing at all. My doctor had the information. I didn’t. It took my being a super sleuth, a cancer-diagnosed, fighting-for-my-life patient to discover that I had something that prevented radiologists from even seeing my cancer on a mammogram—dense breast tissue DBT…

...My outrage spurred me to enter state Sen. Joe Simitian’s annual “There Oughta Be A Law” contest. My winning entry resulted in the introduction of Senate Bill 173, which simply asks that the information that doctors and radiologists already have about a woman’s breast density be relayed to them in the annual letter they receive. It’s a small piece of information, but a vital piece that could spur many women to get the additional screenings they need before it’s too late.

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State Senator Joe Simitian’s (D-Palo Alto) bill aimed to increase breast cancer detection passed the State Senate yesterday on a vote of 34 to 5. Senate Bill 173 requires that following a mammogram individuals with dense breast tissue be informed that dense breast tissue may make cancer more difficult to discern and that they may wish to discuss additional screenings. read more ...

For seven years, Amy Colton did everything right. The registered nurse carefully followed a yearly mammogram routine and conducted monthly self-examinations, all in the hope of screening for breast cancer.

But after seven years of precaution, Colton was diagnosed with breast cancer in 2009. Only later did she learn that women like herself with dense breast tissue are four to six times more likely to be diagnosed with breast cancer.

“I was never informed that I had dense breast tissue,” Colton said. “Everyone should have this information about their own physiology.”

Using her own experience as motivation, Colton entered state Sen. Joe Simitian’s “There Oughta be a Law” contest in hopes of translating her idea of dense breast tissue disclosure into possible legislation. Her bill was one of four winners announced last week — two new bills and two previous winners that will be reintroduced after failing to make it into law in past years.

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State Senator Joe Simitian (D-Palo Alto) has announced two winners in this year’s “There Oughta Be a Law” contest. The winning entries would improve screening for breast cancer, suggested by Amy Colton of Soquel, and update privacy protections for library patrons, suggested by Mary Minow of Cupertino. Simitian has introduced bills to turn those proposals into law read more ...