NJ Breast Density Law Increased Screening, Reduced Biopsies

Supplemental screening ultrasound and MRI examinations among women with dense breast tissue increased after the implementation of The New Jersey breast density law (NJBDL), while use of MRI reduced the number of biopsies, according to a study published in the Journal of the American College of Radiology.

Researchers from Rutgers New Jersey Medical School in Newark and Barnabas Health Ambulatory Care Center in Livingston, both in NJ, performed a retrospective chart review to assess the impact of the NJBDL on further screening and breast cancer diagnosis.

Data from a review of all patients with core biopsy-proven malignancy at a large outpatient breast center from November 1, 2012 to October 31, 2015, were divided into the 18-month period before the implementation of the NJBDL (November 1, 2012 to April 30, 2014) and the 18-month period after passage of the law (May 1, 2014 to October 31, 2015).

The results showed that the use of screening ultrasound increased significantly after the implementation of the NJBDL, by 651% (1,530 versus 11,486). Use of MRI increased by 59.3% (2,595 versus 4,134). A total of 1,213 cancers were included in the final analysis, 592 in the first time period and 621 after law implementation. Breast cancer was most commonly detected on screening mammography, followed by diagnostic mammography with ultrasound for palpable concern, in both time periods. One hundred sixty-two of the 621 cancers analyzed (26.1 %) were found in patients 50 years old or younger.

“The NJBDL succeeded in publicizing the masking effect of dense breasts,” the researchers concluded. Not only did the use of supplemental screening ultrasound and MRI examinations increase after the implementation of this legislation, but the use of MRI increased core biopsy efficiency and reduced the number of biopsies needed per cancer diagnosed.