Many doctors and patients alike will say that diagnosing breast cancer early saves lives, and part of that is knowing enough to make informed decisions, including when a person has dense breast tissue.
Breast density refers to the amount of fat and tissue in the breast as seen on a mammogram, according to Susan G. Komen for the Cure. The organization says women with dense breast have an increased risk of breast cancer.
"When you have dense breast tissue it turns up as white, but cancer turns up as white," Eydith Kaufman said referring to mammogram images. Kaufman lost her partner Janina Hurtado, 45, to an aggressive cancer that she says began as breast cancer. She says Hurtado had a mammogram two months before her diagnosis.
"She knew had some cysts but she was never told that she had dense breast tissue," Kaufman said.
A new law in California now makes talking about dense breast tissue mandatory and a push to have a similar law is going national.
Dense breast tissue laws are now popping up across the country, in 19 states including California according to areyoudenseadvocacy.org, and 40 percent of women have dense breast tissue.
The law in California passed in 2012 and went into effect April 2013. It requires a facility performing a mammogram to tell a patient she or he has the condition and suggest speaking about further screening options.
"I think most women, if they are educated and they are aware of what the options are, at least they can have a meaningful dialogue with their physician and come up with a plan," Kaufman said.
Plans can include automated whole breast ultrasound screenings, innovative technology called Sonocine. Developed by Dr. Kevin Kelly from the Breast Ultrasound Center in Pasadena, the software takes precise, equally spaced images and can find masses as small as 5 mm.
"It's a computer hand on the technologist hand getting the right speed and coverage of the entire breast," Kelly said.
The cost of this screening runs from $250 to $350, Kelly said, and is covered by some insurance companies.
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Density laws in general have been criticized for their potential for malpractice cases and false positive diagnosis.
A patient or Kelly who works with him, Chiqueeta Jameson, carries the memory of a misdiagnosed lump around the country.
"Two gynecologists and one breast surgeon, not one of them did an ultrasound," she said.
She and two other women run the non-profit group called The Dangerous Boobs Tour.
“We want to educate every women in this country,” Jameson said.
And that education can be empowering. Kaufman says it can also save lives.
"Everybody agrees that the best thing for cancer is early detection," Kaufman said. "Nobody disagrees with that and Janina didn't have that gift."
Sen. Dianne Feinstein, D-California, is a co-sponsor of federal legislation that would create a national dense breast tissue standard and make reporting mandatory across the country. A Feinstein spokesperson says the bill will be reviewed after the elections in November.