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Margie’s Law Signed by Governor Kemp

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SAVANNAH, GA (WTOC) – Governor Brian Kemp signed Margie’s Law on Thursday.

Click here to watch the video on WTOC

The law requires healthcare facilities performing mammograms to inform patients if dense breast tissue was detected. It’s named after a Savannah woman, Margie Singleton, who has been advocating for the legislation since she was diagnosed with breast cancer.

In August of 2017, Margie Singleton went in to have her 3D mammogram. It was clear. Six months later, she found a lump in her breast that was sore to the touch. She went back to the doctor and had an ultrasound, and found out she had breast cancer. The same day she got her diagnosis, she also had two 3D mammograms and they didn’t detect the cancer because she had dense breast tissue.

“Mammograms are great if they find something, but a lot of times when the tissue is very dense, it’s difficult to see through that tissue and see if there is a small cancer,” said Dr. William Burak, Memorial Health.

Dr. Burak at Memorial Health is Margie’s breast surgeon. Margie says he’s been with her every step of the way, including in her recovery and in getting the law passed.

“To know that we are now empowering other women to have that knowledge to make those decisions to help protect themselves and to save lives is something that – it’s unexplainable,” Singleton said.

Dr. Burak says the law will give women a better understanding of how accurate mammograms are.

Starting July 1, when a woman gets a mammogram, the doctor will have to let them know if they have dense breast tissue and if they should think about getting an ultrasound or a breast MRI.

“It’s important for us now to have the ability to go to the insurance companies and say ‘Hey, look, this patient needs further testing. The mammogram isn’t accurate. We need to get an MRI.,” Dr. Burak said.

Margie and her army dressed in pink made their way to the Governor’s Mansion last week to watch Governor Kemp sign the bill into a law.

“It was surreal that we actually did it; that we set out to make this change for all of women, and it came to fruition. Outside of having my child, there was no better joy that I’ve ever experienced in life,” Singleton said.

Margie’s Law Heard by the Senate Health and Human Services Committee

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ATLANTA (February 20, 2019) | Today, House Bill 62 was heard by the Senate Health and Human Services Committee, chaired by Senator Ben Watson (R – Savannah). This legislation would require a healthcare facility conducting mammograms to notify a patient if their mammogram demonstrates dense breast tissue.

“I am proud to be hearing such an important bill that could save the lives of thousands of Georgians by increasing the chance of early detection of breast cancer,” said Sen. Watson. “If a woman is taking all proper preventative measures like getting a mammogram, her care center should be voicing any results that may cloud a potential cancer diagnosis, like dense breast tissue. Currently, several other states require this and it has proved vital to making women aware of why a mammogram might not be sufficient for those with dense tissue. I am glad there are citizens, like Ms. Singleton, who are aware of positive changes we can make statewide to help women see the warning signs of cancer.”

Representative Sharon Cooper (R – Marietta), Chairwoman of the House Health and Human Services Committee, sponsored HB 62. This bill was brought to the attention of legislators by Savannah local, Margie Singleton, who has been an advocate for this law since being diagnosed with breast cancer six months after receiving a clean mammogram.

“This is something that is prevalent with not only me, Margie Singleton, but across the nation,” said Ms. Singleton. “I have learned that since my diagnosis there are 37 states that have passed law similar to this because having dense breast tissue does make them more at risk for breast cancer. So, I am here today trying to make this a law in Georgia so we can help protect other women so they do not have to go through this.”

The bill will be carried by Sen. Watson in the Senate. You can follow the progress of the bill here:

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Sen. Ben Watson is Chairman of the Health and Human Services Committee. He represents the 1st Senate District, which includes portions of Chatham County, all of Bryan County, and most of Liberty County. He may be reached by phone at 404.656.7880 or by email at

Georgia on track to be the 37th state with Dense Breast legislation thanks to GA House Bill 62

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On Monday, February 11th, 2019 the Georgia House passed House Bill 62, paving the way for Georgia to become the 37th state with legislation requiring that women who receive a mammogram be notified about their breast density and the implications it could have. Breast density is one of the most common reasons for the failure of a mammography to detect cancer and presents unique challenges for breast cancer patients and providers. Because dense breast tissue has the potential to mask cancerous tumors in mammography results, many women don’t learn they have breast cancer until their disease has reached an advanced stage.

The bill was introduced by Rep. Sharon Cooper (R), chair of the Health & Human Services committee thanks to awareness raised by Georgia resident Margie Singleton. Margie received a delayed diagnosis of breast cancer in 2018 because her tumor was missed on earlier normal mammograms because it wasn’t visible due to the dense breast tissue.

Since 2009, thirty-six states have passed similar legislation, started by the efforts of the late Dr. Nancy Cappello and the AreYouDense? Advocacy organization. Nancy created this organization after her dense breast tissue resulted in a Stage 3c breast cancer diagnosis six weeks after receiving a “normal” mammography report. She championed dense breast legislation first in her home state of Connecticut and then expanded her reach nationally.


In Georgia, Margie started “Margies Army” to pass similar legislation in Georgia.


Section 1, lines 35-43 of House Bill 62 states:

If a patient’s mammogram demonstrates dense breast tissue, the health care facility that conducted the mammogram shall provide notification to the patient that includes, but is not limited to, the following information, in the summary of the results of a mammography examination that is sent directly to a patient pursuant to 42 U.S.C. Section 263b:

Your mammogram shows that your breast tissue is dense. Dense breast tissue is very common and is not abnormal. However, dense breast tissue can make it more difficult to detect cancer through a mammogram. Also, dense breast tissue may increase your risk for breast cancer. This information about the result of your mammogram is given to you to increase your awareness. Use this information to talk with your health care provider about whether other supplemental tests in addition to your mammogram may be appropriate for you, based on your individual risk. A report of your results was sent to your ordering physician. If you are self-referred, a report of your results was sent to you in addition to this summary.”

Who does this bill affect? 95% of women do not know their breast density and less than one in 10 women learn about their dense breast tissue from their doctors. Not just women are impacted by breast cancer diagnoses, as this disease affects family members, friends, and loved ones as well. According to the National Breast Cancer Organization, 1 in 8 women are diagnosed with breast cancer in their lifetime. As women with dense breast tissue are at a higher than average risk of breast cancer, this bill could have a significant impact on breast cancer detection in the state of Georgia if passed.

“I’m grateful for everyone that has supported this bill so far.” said Margie Singleton. “I hope that the Senate will pass this bill soon as well so that all women in Georgia will be informed about their breast density and that some of them can be spared what I had to go through.”


Ladies, This is Serious. Are you Dense?

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This Life with Gracie, By Gracie Bonds Staples, The Atlanta Journal-Constitution

The moment Margie Singleton hit the recommended age to get a mammogram, she signed up and made the trip to her doctor. She would repeat this annual ritual like clockwork, and each time, the news was good.

Singleton might not have known that except one day while exercising in January, she felt a sore lump. At first, she thought it might be the result of some hormonal tic and would go away, but weeks passed and it didn’t.

Read the whole article here.

Margie Singleton wants to educate women about the importance of breast density

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Savannah, GA – (WSAV3, by Kim Gusby)

October is Breast Cancer Awareness Month, but breast health is a topic that should be discussed seven days a week, 365 days a year.
Margie Singleton knows this all too well. She is currently fighting an aggressive form of breast cancer.
She hopes to bring more awareness around breast cancer prevention by focusing attention on breast density and why it matters.

Original post here.

Margie’s Army fighting to improve standard of care for Georgia women

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Margie Singleton is on a mission, and she’s got the power of an army behind her.

Singleton, who has been battling an aggressive form of breast cancer since being diagnosed in February, has her sights set on the Georgia Legislature to change the standard of care of how breast density is included on mammogram reports.

“It is statistically known that mammograms are missing cancer in every other patient with dense breast tissue,” she said. “Women need to be educated and they need to be given a choice.”

Read the whole article here.

New JACR Study Shows Dense Breast Reporting Laws Significantly Increase Breast Density Awareness, Conversations Between Women and Physicians on Screening

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The Journal of the American College of Radiology (JACR) and the nonprofits, Are You Dense, Inc. and Are You Dense Advocacy, Inc. today announced study results showing that dense breast reporting laws in the United States significantly increase breast density awareness as well as prompt conversations between women and their healthcare providers about supplemental screening. Furthermore, the study shows that nearly 90 percent of women surveyed, regardless of the state’s law status, completely or mostly agree that they would prefer to know their breast tissue type than not know.

“Women and their physicians should talk about the woman’s breast density and its impact on breast cancer screening and diagnosis. At the American College of Radiology’s urging, inclusion of breast density information in mammography reports to physicians began long ago based on the ACR’s BI-RADS classification system. In states without legislation, women may not automatically receive density information but should be aware that it is generally available in the mammography report. This information is helpful for both radiologists and referring providers as they discuss density status with their patients,” said Dana Smetherman, MD, FACR, and chair of the American College of Radiology (ACR) Breast Imaging Commission.

Study results also show that women from states where density reporting laws have been in place longer are more likely to know their own density type and to report that their provider talked to them about supplemental screening.

“These study results confirm that women who participate in mammography screening want this important breast health information, and that the mammogram results letter leads to further conversations between them and their physicians about breast screening,” states lead study author Nancy M. Cappello, Ph.D, founder of Are You Dense, Inc. and Are You Dense Advocacy, Inc. and the inspiration behind the first density reporting law in the United States, which has led to 36 state laws. “This is particularly important as it shows that these laws, despite how they’re written, promote informed patient-provider shared decision making.”

Study co-author Christoph Lee, MD, MS, Professor of Radiology and Health Services at the University of Washington School of Medicine states, “The results from this national survey suggest that density reporting laws are associated with improved awareness of breast density and is associated with greater engagement between women and their providers. This type of engagement is important for more personalized, risk-based screening efforts.”

Are You Dense, Inc. and Are You Dense Advocacy, Inc. commissioned this survey of U.S. women to determine their knowledge about dense breast tissue and its masking of and risk factor for breast cancer, their preferences on learning about their dense breast tissue status after having a mammogram and as a result of notification, whether or not they had subsequent conversations with providers about supplemental screening.

The survey, conducted in February 2018, included 1,500 women in all 50 states, between 40 and 74 years old, who had a mammogram within the past two years. Survey results were compared across five groups based on law details and between women residing in states with laws versus without laws. While the majority of women in each of the sample groups were white, there was representation of minority women in each of the groups.

Science for decades has demonstrated that dense breast tissue is associated with a higher-than-average risk of breast cancer and that dense breast tissue can mask cancers on mammograms, making them impossible to detect. Adjunct screening to mammography, such as ultrasound and MRI, significantly increase detection of early cancers in dense breasts.

Dr. Cappello launched the legislative action of her organizations after being diagnosed with advanced-stage breast cancer in 2004 despite decades of normal mammography results. None of Dr. Cappello’s physicians told her that she had dense breast tissue, which had hidden the growing cancer in her breast, and none advised her to get adjunct screening.

Adds Dr. Cappello, “Today’s study results further support our relentless mission to reduce missed, delayed and advanced stage breast cancer by increasing access to early detection for women with dense breasts leading to reduced harms from aggressive treatments and better survival outcomes.”

Learn more about breast density and its relationship to breast cancer risk and legislative efforts across the U.S. at areyoudense.organd You can also visit and download the ACR Breast Density Brochure.

About Are You Dense, Inc. and Are You Dense Advocacy, Inc.
Nancy Cappello, Ph.D. is director and founder of Are You Dense, Inc., a 501(c)(3) public charity and Are You Dense Advocacy, Inc., a 501(c)(4) public charity. Dr. Cappello is the architect of using legislative efforts to standardize the communication of breast density to patients through the patient’s mammography reporting results, starting with her state of Connecticut in 2009. Alongside patients turned advocates, Dr. Cappello has visited with and testified before state legislatures, in addition to the MQSA committee of the FDA and led efforts for the introduction of a federal bill in both the House and Senate. She had shared her story at medical and patient-centered conferences across the country and the globe. She is the recipient of numerous awards, including being named a health hero by Parade Magazine and honored for her health advocacy by the Connecticut Women’s Hall of Fame.

About the Journal of the American College of Radiology
The official journal of the American College of Radiology, JACR informs its readers of timely, pertinent, and important topics affecting the practice of diagnostic radiologists, interventional radiologists, medical physicists, and radiation oncologists. In so doing, JACR improves their practices and helps optimize their role in the health care system. By providing a forum for informative, well-written articles on health policy, clinical practice, practice management, data science, and education, JACR engages readers in a dialogue that ultimately benefits patient care.

Dense Breast Tissue Complicates Mammograms

By | Uncategorized | No Comments – By NANCY M. CAPPELLO

Most women — and their doctors — tend to think of mammography as a one-scan-works-for-all test. I learned the hard way that it isn’t.

When I turned 36, I had a baseline mammogram. Then, beginning at age 40, I dutifully had a mammogram every year, convinced that it was the best way to detect breast cancer early should it ever appear. Six weeks after my 11th “normal” mammogram, my gynecologist felt a ridge in my right breast. An ultrasound revealed a quarter-sized tumor. When I received the startling news that I had stage 3C breast cancer, an advanced stage of breast cancer that had spread to 13 lymph nodes, I felt betrayed by the health community. At that time, in 2004, a woman like me with stage 3C breast cancer had a 49 percent chance of surviving five years.

Read the whole article here.