What you should know about


What is Henda's Law & how does it affect my mammogram?

Henda's Law is the informal name for a House Bill passed by Texas Legislature that requires mammography providers to inform women that dense breast tissue can affect the accuracy of a mammogram in detecting breast cancer.
The bill was initiated by Henda Salmeron, whose breast cancer went undetected because routine mammograms did not pick up on cancerous tumors. Women, like Henda, who have dense breast tissue may benefit from supplemental screening.

Do I have dense breast tissue?

Breast density refers to the amount or ratio of fibroglandular to fatty tissue. As a woman ages, fibroglandular tissue is replaced by an increase in fatty tissue and thus making breast cancer more readily visualized on a mammogram.

Henda Salmeron

How will this affect my annual exam?

If a physician notices you have dense breast tissue, additional exams such as ultrasound may be ordered to rule out the possibility of any hidden tumors. However, it is important that you know insurance may not cover these additional screenings at 100%.


The American College of Radiology (ACR) came up with a standard way to describe mammogram findings and results. In this system, the results are sorted into categories numbered 0 through 6. This system is called the Breast Imaging Reporting and Data System (BI-RADS). Having a standard way of reporting mammogram results lets doctors use the same words and terms, which can help ensure better follow up of suspicious findings. These categories are used in the official report that goes to your doctor. Different wording may be used in the letters sent to patients. Here’s a brief review of the categories:

Additional imaging evaluation and/or comparison to prior mammograms is needed.

This means a possible abnormality may not be clearly seen or defined and more tests are needed, such as the use of spot compression (applying compression to a smaller area when doing the mammogram), magnified views, special mammogram views, or ultrasound. This may also suggest that the mammogram should be compared with older ones to see if there have been changes in the area over time.


There’s no significant abnormality to report. The breasts look the same (they are symmetrical) with no masses (lumps), distorted structures, or suspicious calcifications.

Benign (non-cancerous) finding

The radiologist describes a finding to be benign, when he/she sees benign, non malignant, structures such as, calcifications, lymph nodes in the breast, benign cysts or calcified fibroadenomas. This ensures that others who look at the mammogram will not misinterpret the benign finding as suspicious. This finding is recorded in the mammogram report to help when comparing to future mammograms.

Probably benign finding – Follow-up in a short time frame is suggested

The findings in this category have a very high chance (greater than 98%) of being benign (not cancer). The findings are not expected to change over time. But since it’s not proven benign, it’s helpful to see if the area in question does change over time. Follow-up with repeat imaging is usually done in 6 months and regularly after that until the finding is known to be stable (usually at least 2 years). This approach helps avoid unnecessary biopsies, but if the area does change over time, it still allows for early diagnosis.

Suspicious abnormality – Biopsy recommended

Findings do not definitely look like cancer but could be cancer. The radiologist is concerned enough to recommend a biopsy.

Highly suggestive of malignancy – Biopsy recommended

The findings look like cancer and have a high chance (at least 95%) of being cancer. Biopsy recommended.

Known biopsy-proven malignancy – Appropriate action should be taken

This category is only used for findings on a mammogram that have already been shown to be cancer by a previous biopsy. Mammograms may be used in this way to see how well the cancer is responding to treatment. Some cancers are often made to shrink using chemotherapy to later be removed by a surgeon.

Information from ACR, American College of Radiology, and the American Cancer Society.

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