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Radiology. 2013 Dec;269(3):887-92. doi: 10.1148/radiol.13131217. Epub 2013 Oct 28.

The California breast density information group: a collaborative response to the issues of breast density, breast cancer risk, and breast density notification legislation.

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From the Departments of Radiology and Biomedical Imaging, Division of Women's Imaging (E.R.P., E.A.S., B.N.J.), and Radiology (R.J.B.), University of California, San Francisco, San Francisco, Calif; Department of Radiology (J.H, K.K.L.) and the Comprehensive Cancer Center (D.D.W.), University of California, Davis, Sacramento, Calif; Department of Radiology, Stanford University School of Medicine, Advanced Medicine Center, 875 Blake Wilbur Dr, Room CC-2239, Stanford, Calif (J.A.L., D.M.I.); Bay Imaging Consultants, Sutter Health, Alta Bates Summitt Medical Center, Carol Ann Read Breast Health Center, Oakland, Calif (R.J.B.); Department of Radiology, Sutter Health, California Pacific Medical Center, San Francisco, Calif (J.W.T.L.); Department of Radiology, University of California, Irvine Medical Center, Fong and Jean Tsai Professor of Women's Imaging, University of California Irvine School of Medicine, UCI Medical Center, Orange, Calif (S.A.F.); Department of Radiology, University of California, Los Angeles, Los Angeles, Calif (L.W.B.); Department of Clinical Radiology, Moores Cancer Center, UC San Diego Health System, La Jolla, Calif (H.O.F.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (B.L.D.); Divisions of Oncology and Epidemiology, Stanford University School of Medicine, Stanford, Calif (A.W.K.); Department of OB/GYN, UC Davis Health System, University of California Davis Cancer Center, Sacramento, Calif (E.L.); and Athena Breast Health Network and UCSF Cancer Risk Program, San Francisco, Calif (L.R.).


In anticipation of breast density notification legislation in the state of California, which would require notification of women with heterogeneously and extremely dense breast tissue, a working group of breast imagers and breast cancer risk specialists was formed to provide a common response framework. The California Breast Density Information Group identified key elements and implications of the law, researching scientific evidence needed to develop a robust response. In particular, issues of risk associated with dense breast tissue, masking of cancers by dense tissue on mammograms, and the efficacy, benefits, and harms of supplementary screening tests were studied and consensus reached. National guidelines and peer-reviewed published literature were used to recommend that women with dense breast tissue at screening mammography follow supplemental screening guidelines based on breast cancer risk assessment. The goal of developing educational materials for referring clinicians and patients was reached with the construction of an easily accessible Web site that contains information about breast density, breast cancer risk assessment, and supplementary imaging. This multi-institutional, multidisciplinary approach may be useful for organizations to frame responses as similar legislation is passed across the United States. Online supplemental material is available for this article.

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