The density conundrum: does legislation help or hurt?

Breast density and breast density legislation are controversial and potentially emotional issues in breast screening. Informing individual patients of their breast density status is an extremely important and highly personal conversation that must focus on patients' specific situations. The unanswered questions about converting population risk make it difficult to provide an individual woman with an explanation of what breast density means to her individual risk for developing breast cancer now or in the future. There are no standards or guidelines for what doctors should tell patients about their risk with dense breasts, and legislating the conversation may not improve it or a woman's response to the information. It is necessary to learn more about breast density, understand its meaning, and communicate clearly and compassionately with patients about what we know and what we do not know about breast cancer risk. Precipitous legislation can, in fact, undermine both the patient-physician relationship and the need for more evidence that would expand our understanding of the risk associated with breast density.