The Wall Street Journal poses an interesting question for both the specialty of radiology and the millions of women in 21 states who will be notified that they have dense breasts: What should they do about it?

While it recognizes the emergence of new technologies that promise better detection of cancers, the “New Screening Tests for Hard-to-Spot Breast Cancers” raises a number of issues for women receiving such a notice. They include an increased probability of false positives and the fact that most alternatives to mammography are more expensive.

“It’s a very confusing time,” Emily Conant, MD, chief of breast imaging, University of Pennsylvania Medical Center, told the WSJ. “This legislation has happened before we have a medical consensus about what to tell women.”

While Conant said that all women who are imaged at the University of Pennsylvania Medical Center  women’s center receive breast tomosynthesis, the JAMA study in which she participated did not look specifically at women with dense breasts.

The article also cites contradictory thinking  on breast ultrasound, the expense of breast MRI and the increased radiation dose associated with molecular breast imaging.

“Doctors say that a large, randomized clinical trial comparing all the options for women with dense breasts would be helpful,” the author writes. “Meanwhile, they can help women understand the pros and cons for themselves whether to seek additional tests.”