Breast Tissue Density and Henda’s Law

Dense breast tissue increases the difficulty in detecting breast cancers on a mammogram thus placing women at greater risk. Breast tissue is composed of a combination of glandular and fatty tissue. Breast density refers to the amount or ratio of these two types of tissues as seen on a mammogram. Younger women (under 40 years of age) generally have very dense breasts. In other words, this is what we expect to see. As a woman ages, the glandular tissue is replaced by an increase in fatty tissue which has the advantage of making breast cancer more readily visualized on mammography. Women using hormone therapy may continue to have denser breasts even after menopause. Dense tissue looks white or gray on a mammogram, and cancer can also appear white or gray.

Henda`s Law

In 2011, the Texas Legislature passed House Bill 2102, which is known informally as “Henda’s Law”―named after Henda Salmeron, a Dallas realtor and breast cancer survivor who was instrumental in organizing the effort to pass the law in Texas. It is based on a similar law in Connecticut, and requires that mammography providers inform women that dense breast tissue can affect the accuracy of mammography in detecting breast cancer, and women with dense breasts plus additional risk factors may benefit from supplemental screening. The mandated language for the notification reads:

Texas H.B. 2102 – Henda’s Law – Breast Density
If your mammogram demonstrates that you have dense breast tissue, which could hide abnormalities, and you have other risk factors for breast cancer that have been identified, you might benefit from supplemental screening tests that may be suggested by your ordering physician.

Dense breast tissue, in and of itself, is a relatively common condition. Therefore, this information is not provided to cause undue concern but rather to raise your awareness and to promote discussion with your physician regarding the presence of other risk factors, in addition to dense breast tissue.

A report of your mammogram results will be sent to you and your physician. You should contact your physician if you have any questions or concerns regarding this report.

For consistency, the American College of Radiology has four grades of breast composition to describe the breast density of all patients using the following patterns:

  • Type 1: fatty (<25% glandular tissue)
  • Type 2: scattered (25-50% scattered fibroglandular tissue)
  • Type 3: heterogeneously dense
  • Type 4: dense (>75% fibroglandular)

Supplemental screening exams include breast ultrasound, Tomosynthesis (3D screening), MRI or molecular breast imaging. There are pros and cons to these exams, and women at high risk (i.e., have a first-degree maternal or paternal relative diagnosed prior to menopause) should discuss their individual risk, breast tissue density and the need for supplemental tests with their healthcare provider or the RN Nurse Navigator at their imaging/mammography center.

For more information, contact Laura Fritz, RN, APRN, Nurse Navigator at The Breast Center at St. David`s Medical Center at 512-544-8800.

**COMING SOON: 2D/3D Tomosynthesis mammography only at The Breast Center at St. David`s Medical Center

One Response to “Breast Tissue Density and Henda’s Law”

  1. DebDrive July 11, 2013 at 2:19 pm #

    At the moment, getting these laws in place is a state-by-state effort. I’m happy to see that Connecticut and Texas got the ball rolling in 2011. Since then, similar bills have been signed into law in Virginia, New York, California, Hawaii, Maryland, Tennessee, Alabama, and Oregon (some have not yet been enacted, however). Other states are working on it.

    I live in Colorado and am working with someone who is a strong advocate and activist for such a law in our state.

    Thank you for helping to create awareness. We all need to get the word out!

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