,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #ajgfc  ,,9 ,,! ,,h\se ,,(         
,,repres5tatives  ,octob] #f1 #bjbf,ms4 
,letl[ introduc$ ! foll[+ bill2 :i* 0   
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce  ,a ,,bill  ,to direct !       
,secret>y ( ,heal? & ,human ,s]vices to 
submit to ,congress a report on brea/   
canc] risk assessm5t tools1 & = o!r     
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,"k ,y\r ,risk ,act4  #b4  
,f9d+s ,congress f9ds ! foll[+3 7#a7 ,9 
#bjbf1 approximately #chb1fdj wom5 9 !  
,unit$ ,/ates w be diagnos$ ) brea/     
canc]4  7#b7 ,e>ly detection ( brea/    
canc] is associat$ ) improv$ survival   
rates1 includ+ a #e-ye> relative        
survival rate ( approximately #ii p]c5t 
= canc]s detect$ at a localiz$ /age4    
7#c7 ,9 ! ,unit$ ,/ates alone1 wom5 h a 
#a-;9-#h lifetime risk ( be+ diagnos$ ) 
brea/ canc]4  7#d7 ,approximately #he   
p]c5t ( individuals diagnos$ ) brea/    
canc] h no family hi/ory ( ! disease4   
7#e7 ,! risk t an individual w develop  

brea/ canc] is influ5c$ by factors      
includ+ age1 race1 e?nicity1 g5etic     
mutations1 reproductive hi/ory1 brea/   
d5sity1 family hi/ory1 & exposures to   
c]ta9 drugs4  7#f7 ,mo/ risk factors =  
brea/ canc] d n directly cause canc] b d
 increase ! *ance ( ,,dna damage 9 cells
 t may lead to brea/ canc]4  7#g7 ,brea/
 canc] risk assessm5t tools support     
heal? c>e provid]s 9 e/imat+ ! risk t a 
woman w develop brea/ canc] & in=m+     
appropriate scre5+1 detection1 treatm5t1
 & prev5tion /rategies4  7#h7 ,multiple 
brea/ canc] risk assessm5t tools exi/1  
includ+ ! ,national ,canc] ,in/itute's  
,gail ,model & ! ,tyr]-,cuzick ,risk    
,assessm5t ,calculator4  7#i7 ,despite !
 availability ( su* tools1 !re is no    
s+le1 c5traliz$1 or widely recogniz$    
brea/ canc] risk assessm5t tool =       
pati5ts1 provid]s1 & heal? sy/ems4      
7#aj7 ,/r5g!n+ education & aw>5ess (    
brea/ canc] risks & ( tools t assess su*
 risks c alleviate disp>ities 9 e>ly    
detection & treatm5t across geographic  

regions1 age gr\ps1 & heal? c>e sett+s4 
7#aa7 ,9 #bjbe1 ! ,food & ,drug         
,adm9i/ration grant$ ,de ,novo          
au?orization to ! fir/ artificial       
intellig5ce-bas$ mammogram risk         
assessm5t tool to pr$ict brea/ canc]    
risk1 fur!r exp&+ ! range ( available   
tools b also increas+ ! ne$ = improv$   
coord9ation & evaluation ( me?odologies 
to rea* a broad] range ( wom54  7#ab7   
,increas+ ,f$]al inve/m5ts 9 brea/ canc]
 rese>* & /r5g!n+ public-private        
p>tn]%ips is ess5tial to /reaml9e !     
curr5t pat*work ( brea/ canc] risk      
assessm5t tools to improve consi/5cy &  
access :ile enabl+ e>li] & m accurate   
detection = wom5 nationwide4  #c4       
,report on brea/ canc] risk assessm5t   
tools  7a7 ,9 g5]al ,n lat] ?an #ahj    
days aft] ! date ( enactm5t ( ?is ,act1 
! ,secret>y ( ,heal? & ,human ,s]vices  
%all submit to ,congress a report t     
includes-- 7#a7 id5tification (         
inaccuracies result+ f ! use ( exi/+    
brea/ canc] risk assessm5t tools2  7#b7 

gaps 9 use ( exi/+ brea/ canc] risk     
assessm5t tools among diff]5t           
populations2 &  7#c7 factors t          
contribute to su* inaccuracies & gaps 9 
use4  7b7 ,developm5t ( compreh5sive    
brea/ canc] risk assessm5t tool ,!      
report "u subsection 7a7 %all include-- 
7#a7 an outl9e ( ! plann+ ne$$ to create
 a s+le brea/ canc] risk assessm5t tool 
t is compreh5sive & publicly accessible2
  7#b7 /rategies to provide = public    
aw>5ess ( su* a brea/ canc] risk        
assessm5t tool2 &  7#c7 recomm5dations  
on h[ to build cons5sus on ! developm5t 
( su* a brea/ canc] risk assessm5t tool 
among-- 7,a7 pati5ts2  7,b7 m$ical      
provid]s2  7,c7 in/itutions ( high]     
education2  7,d7 =-pr(it & nonpr(it     
entities2  7,e7 heal? c>e entities 7z   
def9$ 9 section #fj4c ( title #de1 ,code
 ( ,f$]al ,regulations 7or any successor
 regulation772 &  7,f7 o!r entities1 z !
 ,secret>y det]m9es relevant4  #d4      
,brea/ canc] risk assessm5t requirem5t 9
 grant programs  7a7 ,brea/ canc] risk  

assessm5t requirem5t  7#a7 ,grant       
requirem5ts ,section #aeja7;a7 ( !      
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjjk7 is am5d$-- 7,a7 9      
p>agraph 7#a71 by ins]t+ conduct        
evid5ce-bas$ brea/ canc] risk assessm5ts
 & to be=e scre5 wom52  7,b7 9 p>agraph 
7#d71 by ins]t+ 1 includ+ tra9+ on &    
cl9ical application ( validat$ brea/    
canc] risk assessm5t models be=e !      
semicolon at ! end2  7,c7 9 p>agraph    
7#e71 by /rik+ 2 & & ins]t+ a semicolon2
  7,d7 by r$esignat+ p>agraph 7#f7 z    
p>agraph 7#i72  7,e7 by ins]t+ aft]     
p>agraph 7#e7 ! foll[+3  7#f7 to        
implem5t /&>diz$1 evid5ce-bas$ brea/    
canc] risk assessm5t tools 9 appropriate
 cl9ical sett+s1 includ+ ?r\gh          
integration into electronic heal? record
 sy/ems2  7#g7 to develop & dissem9ate  
public in=mation & education programs   
reg>d+ brea/ canc] risk factors1        
individualiz$ risk assessm5t1 g5etic    
pr$isposition1 & available risk-r$uction
 /rategies2  7#h7 to support rese>*1    

validation1 & improvem5t ( exi/+ brea/  
canc] risk assessm5t models to improve  
accuracy across racial1 e?nic1          
geographic1 & age populations2 &  2 &   
7,f7 9 p>agraph 7#i71 z r$esignat$1 by  
/rik+ 7#e7 & ins]t+ 7#h74  7#b7 ,con=m+ 
am5dm5ts ,section #aejc ( ! ,public     
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjjmm7 is am5d$-- 7,a7 9 subsection    
7a77#d71 by /rik+ 7#f7 & ins]t+ 7#i72 & 
7,b7 9 subsection 7d77#c77;,b77ii71 by  
/rik+ 7#f7 & ins]t+ 7#i74  7b7 ,risk    
assessm5t report+ ,section #aejd7;i7 ( !
 ,public ,heal? ,s]vice ,act 7#db       
,u4,s4,c4 #cjjn7 is am5d$ to read z     
foll[s3  7i7 ,reports to ,secret>y  7#a7
 ,requir$ reports ,! ,secret>y may n    
make a grant "u section #aeja unless !  
,/ate involv$ agrees to submit to !     
,secret>y ! report requir$ "u p>agraph  
7#b7 & su* o!r reports z ! ,secret>y may
 require ) respect to ! grant4  7#b7    
,risk assessm5t report+ ,a ,/ate receiv+
 a grant "u section #aeja %all submit to
 ! ,secret>y1 at su* "t & 9 su* mann] z 

! ,secret>y may require1 in=mation on-- 
7,a7 ! numb] ( individuals receiv+ brea/
 canc] risk assessm5ts "u ! programs ( !
 ,/ate fund$ ?r\gh su* grant2  7,b7 !   
numb] & p]c5tage ( individuals receiv+  
brea/ canc] risk assessm5ts "u su*      
programs id5tifi$ z be+ at elevat$ risk2
  7,c7 ! numb] ( ref]rals made = enhanc$
 scre5+1 g5etic c\nsel+1 prev5tive      
!rapy1 or o!r brea/ canc] risk-r$uction 
s]vices ?r\gh su* programs2 &  7,d7     
disp>ities 9 access to brea/ canc] risk 
assessm5ts & foll[-up s]vices among     
geographic regions1 m$ically und]s]v$   
populations1 & o!r populations1 z       
det]m9$ relevant by ! ,secret>y4  4