recently reported that, as of February 15, 2019, it is now federal law in the United States that the Food and Drug Administration (FDA) develop breast density reporting language that must be included in patient letters and health provider reports. Exact language and effective date are not yet available; once the requirement details are in effect, it would set a minimum standard for all U.S. states.

The law directs the FDA, through the regulatory process, to develop reporting language and ensure that mammography reports and summaries received by patients and their providers include appropriate information about breast density. The information must include, at a minimum:

  • The effect of breast density in masking the presence of breast cancer on a mammogram
  • The qualitative assessment of the provider who interprets the mammogram, and
  • A reminder to patients that individuals with dense breast tissue should talk with their providers if they have any questions or concerns about their summary. also answers the following question that will likely be asked by many…

So, when introduced, will the new federal reporting minimum replace existing state laws?

Under the Mammography Quality Standards Act (MQSA), overseen by the FDA, all facilities would have to follow that federal reporting requirement and any specific language associated with it. However, the MQSA explicitly states that nothing in it limits the authority of any State to enact State laws relating to mammography that are at least as stringent as the MQSA or regulations under the MQSA. States might also choose to have any MQSA density reporting requirement supersede their State reporting requirements. Once the new standard is introduced, individual state law review will be necessary.

This is not a completely new issue as more than 30 states currently require such language to be shared with patients after they undergo a mammogram. Click here for a comparative analysis of state density inform efforts and insurance coverage provided by

As always, ADVOCATE will keep you up to date on this and all issues impacting radiology as they become available.


Lauren Sloan, MHA, RD, LD

Director of Regulatory Affairs