I 

111TH CONGRESS 

1ST SESSION H. R. 1740 

To amend the Public Health Service Act to increase awareness of the risks 

of breast cancer in young women and provide support for young women 

diagnosed with breast cancer. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 26, 2009 

Ms. WASSERMAN SCHULTZ (for herself, Mrs. MYRICK, Ms. DELAURO, Mrs. 

CHRISTENSEN, Ms. BEAN, Ms. PELOSI, Ms. BORDALLO, Mr. SERRANO, 

Mrs. CAPPS, Mr. WEINER, Mr. WEXLER, Mr. TONKO, Mr. DAVIS of Alabama, Mr. SABLAN, Ms. MCCOLLUM, Mr. BERMAN, Ms. ROS-LEHTINEN, 

Mr. BACA, Mr. HASTINGS of Florida, Mr. MEEK of Florida, Ms. CASTOR

of Florida, Mr. LINCOLN DIAZ-BALART of Florida, Mr. KLEIN of Florida, 

Ms. FUDGE, Ms. SCHAKOWSKY, Ms. JACKSON-LEE of Texas, Mr. 

MAFFEI, Mr. LARSON of Connecticut, Ms. SUTTON, Mr. CUMMINGS, Mr. 

BURTON of Indiana, Mr. POE of Texas, Ms. LEE of California, Mr. 

MOORE of Kansas, Mr. MARIO DIAZ-BALART of Florida, Ms. MARKEY of 

Colorado, Ms. CLARKE, Mr. PERRIELLO, Ms. KOSMAS, Ms. MATSUI, Mr. 

GENE GREEN of Texas, Ms. HIRONO, Mrs. MCCARTHY of New York, Mr. 

BOREN, Mrs. DAVIS of California, Mr. NADLER of New York, Mrs. 

DAHLKEMPER, Ms. SCHWARTZ, Ms. EDWARDS of Maryland, Ms. KILPATRICK of Michigan, Mr. MURTHA, Ms. BALDWIN, Ms. HARMAN, Mrs. 

EMERSON, Mr. HODES, Mr. HALL of New York, Mr. FATTAH, Mrs. 

TAUSCHER, Ms. NORTON, Mr. CONYERS, Mr. RYAN of Ohio, Mr. JONES, 

Mr. BRALEY of Iowa, Ms. TITUS, Mr. VAN HOLLEN, Mr. ARCURI, Mr. 

WELCH, Ms. HERSETH SANDLIN, Mr. NYE, Mr. CARNEY, Mrs. KIRKPATRICK of Arizona, Mr. DOGGETT, Ms. KILROY, Mr. BARROW, Ms. 

LINDA T. SA ́NCHEZ of California, Mr. WALZ, Mr. DONNELLY of Indiana, 

Mr. BECERRA, Mr. SCHIFF, Mr. SCHAUER, Mr. HINCHEY, Mrs. LOWEY, 

Mr. PERLMUTTER, Mr. ELLISON, Mr. TEAGUE, Mr. COHEN, Mr. DOYLE, 

Mr. MITCHELL, Mr. SESTAK, Mr. MCMAHON, Mr. OLVER, Mr. SHULER, 

Mr. THOMPSON of California, Ms. KAPTUR, Mr. MASSA, Mr. REYES, Mrs. 

MALONEY, Mr. WAXMAN, Ms. SHEA-PORTER, Mr. BOYD, Mr. DICKS, Mr. 

LATOURETTE, Mr. OBEY, Mr. WAMP, Mr. PRICE of North Carolina, Mr. 

MANZULLO, Mrs. BONO MACK, Mr. POSEY, Mr. STEARNS, Mr. TIERNEY, 

Mr. ISSA, Mr. MACK, Mr. SCOTT of Georgia, Mr. CLYBURN, Mr. 

CHILDERS, Mr. CLEAVER, Mr. LUJA ́N, Mr. FOSTER, Mr. KANJORSKI, 

Ms. SPEIER, Mr. HOYER, Ms. RICHARDSON, Mr. PATRICK J. MURPHY

of Pennsylvania, Mr. MURPHY of Connecticut, Mr. BOCCIERI, Mr. WILVerDate Nov 24 2008 06:45 Mar 27, 2009 Jkt 079200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H1740.IH H1740

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SON of Ohio, Mr. NEAL of Massachusetts, Mr. PALLONE, Mr. KRATOVIL, 

Mr. AL GREEN of Texas, Mr. PUTNAM, Mrs. HALVORSON, Mr. KIND, Mr. 

KILDEE, Mr. KENNEDY, Mr. BOOZMAN, Mrs. BIGGERT, Mr. LANCE, Mrs. 

MCMORRIS RODGERS, Mr. YARMUTH, Mr. SHIMKUS, Mr. CARNAHAN, 

Mr. LOEBSACK, Mr. REHBERG, Mr. ALEXANDER, Mr. HEINRICH, Mr. 

SIRES, Mr. ELLSWORTH, Mr. MATHESON, Mr. TAYLOR, Mr. BURGESS, 

Mrs. BLACKBURN, Ms. GINNY BROWN-WAITE of Florida, Mr. BARTON of 

Texas, Mr. CLAY, Mr. HONDA, Mr. FRANK of Massachusetts, Ms. WOOLSEY, Mr. FORTENBERRY, Mr. CRENSHAW, Mr. SAM JOHNSON of Texas, 

Mr. CULBERSON, Mr. MARCHANT, Mr. LUCAS, Mr. SMITH of Texas, Mr. 

KIRK, Mrs. CAPITO, Mr. GONZALEZ, Mr. FALEOMAVAEGA, Mr. LATHAM, 

Mr. CANTOR, Ms. FALLIN, Ms. WATERS, Mr. MELANCON, Ms. ZOE

LOFGREN of California, Mr. OBERSTAR, Mr. RAHALL, Mr. PASTOR of Arizona, Mr. HIMES, Mr. BUYER, Mr. PAYNE, Mr. COSTELLO, Mr. TURNER, and Mr. PRICE of Georgia) introduced the following bill; which was 

referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to increase awareness of the risks of breast cancer in young women and 

provide support for young women diagnosed with breast 

cancer. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Breast Cancer Edu5 cation and Awareness Requires Learning Young Act of 

6 2009’’ or ‘‘EARLY Act’’. 

7 SEC. 2. YOUNG WOMEN’S BREAST CANCER AWARENESS 

8 AND SUPPORT. 

9 Title III of the Public Health Service Act (42 U.S.C. 

10 241 et seq.) is amended by adding at the end the fol11 lowing: 


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1 ‘‘PART S—PROGRAMS RELATING TO BREAST 

2 CANCER 

3 ‘‘SEC. 399HH. YOUNG WOMEN’S BREAST CANCER AWARE4 NESS AND SUPPORT. 

5 ‘‘(a) PUBLIC EDUCATION CAMPAIGN.— 

6 ‘‘(1) IN GENERAL.—The Secretary, acting 

7 through the Director of the Centers for Disease 

8 Control and Prevention, shall conduct a national evi9 dence-based education campaign— 

10 ‘‘(A) to increase public awareness regard11 ing the threats posed by breast cancer to young 

12 women of all ethnic and cultural backgrounds, 

13 including the particular risks faced by certain 

14 ethnic and cultural groups; and 

15 ‘‘(B) focusing on awareness of risk factors 

16 of breast cancer among young women and 

17 achieving early detection of breast cancer 

18 among young women through community-cen19 tered informational forums, public service ad20 vertisements, and media campaigns. 

21 ‘‘(2) AUTHORIZED ACTIVITIES.—In conducting 

22 the education campaign under paragraph (1), the 

23 Secretary may— 

24 ‘‘(A) make public announcements targeted 

25 towards young women with the goal of edu26 cating them that breast cancer occurs in young 


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1 women and the steps they can take to recognize 

2 their individual risk factors and ensure early 

3 detection of breast cancer, ensuring that such 

4 messaging is age-appropriate; 

5 ‘‘(B) provide education, through written 

6 materials, identifying evidence based methods to 

7 lower the risk of breast cancer in young women 

8 through changes in lifestyle including diet, exer9 cise, and environmental factors; 

10 ‘‘(C) conduct other activities determined by 

11 the Secretary to promote educational aware12 ness, early detection, and risk-reducing prac13 tices among young women and increase the 

14 number of young women with breast cancer 

15 warning signs who seek immediate care; 

16 ‘‘(D) award grants, contracts, or coopera17 tive agreements to appropriate State agencies 

18 to carry out secondary school and university 

19 education campaigns, focusing on breast cancer 

20 awareness among young women; 

21 ‘‘(E) develop and distribute to young 

22 women, physicians, and other appropriate 

23 health care professionals, educational mate24 rials— 

25 ‘‘(i) designed for young women; 


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1 ‘‘(ii) relating to particular risk factors 

2 for breast cancer in women under the age 

3 of 40; 

4 ‘‘(iii) identifying methods for increas5 ing early detection, including clinical 

6 breast exams, blood component analysis, 

7 and where there is a increased risk of 

8 breast cancer due to ethnic background, 

9 genetic mutations, or other risk factors, 

10 other predictive tools such as genetic coun11 seling and testing; 

12 ‘‘(iv) identifying methods for increas13 ing self awareness, including breast self 

14 exams, learning how to perform such 

15 exams, and knowing the signs of breast 

16 malignancies; 

17 ‘‘(v) identifying evidenced based meth18 ods to lower the risk of breast cancer 

19 through changes in lifestyle, including diet, 

20 exercise, and environmental factors; 

21 ‘‘(vi) identifying available treatment 

22 options for breast cancer; and 

23 ‘‘(vii) for young women who have been 

24 diagnosed with breast cancer, health inforVerDate Nov 24 2008 06:45 Mar 27, 2009 Jkt 079200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1740.IH H1740

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1 mation from credible sources that provides 

2 information on— 

3 ‘‘(I) fertility preservation; 

4 ‘‘(II) support, including social, 

5 emotional, psychosocial, financial, life6 style, and caregiver support; 

7 ‘‘(III) familial risk factors; and 

8 ‘‘(IV) risk reduction strategies to 

9 reduce recurrence or metastasis; and 

10 ‘‘(F) carry out a health education program 

11 targeted to specific higher-risk populations of 

12 young women based on race, ethnicity, level of 

13 acculturation, and family history, including the 

14 African-American and Ashkenazi Jewish popu15 lations under 40 years of age. 

16 ‘‘(3) MEDIA CAMPAIGN.—In conducting the 

17 education campaign under paragraph (1), the Sec18 retary shall award grants to entities to establish na19 tional multimedia campaigns oriented to young 

20 women that— 

21 ‘‘(A) will encourage young women to be 

22 aware of— 

23 ‘‘(i) their personal risk factors, includ24 ing by talking to their medical practitioner 

25 about those risks; 


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1 ‘‘(ii) strategies for increasing early de2 tection, including clinical breast exams, 

3 and where there is a increased risk of 

4 breast cancer due to ethnic background, 

5 genetic mutations, or other risk factors, 

6 other predictive tools such as genetic coun7 seling and testing; 

8 ‘‘(iii) strategies for increasing self 

9 awareness, including doing breast self 

10 exams, learning how to perform such 

11 exams, and knowing the signs of breast 

12 malignancies; 

13 ‘‘(iv) evidence based preventative life14 style changes, including eating healthily 

15 and maintaining a healthy weight; and 

16 ‘‘(v) other breast cancer early detec17 tion and risk reduction strategies deter18 mined appropriate by the Secretary; 

19 ‘‘(B) will encourage young women of spe20 cific higher-risk populations based on race, eth21 nicity, level of acculturation, and family history, 

22 including the African-American and Ashkenazi 

23 Jewish populations under 40 years of age to 

24 talk to their medical practitioners about those 

25 risks and methods for appropriate screening 


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1 and surveillance, including available genetic 

2 testing and counseling; and 

3 ‘‘(C) may include advertising through tele4 vision, radio, print media, billboards, posters, 

5 all forms of existing and emerging social net6 working media, other Internet media, and any 

7 other media determined appropriate by the Sec8 retary. 

9 ‘‘(4) ADVISORY COMMITTEE.—. 

10 ‘‘(A) ESTABLISHMENT.—Not later than 60 

11 days after the date of the enactment of this sec12 tion, the Secretary, acting through the Director 

13 of the Centers for Disease Control and Preven14 tion, shall establish an advisory committee to 

15 assist in creating and conducting the education 

16 campaign under paragraph (1). 

17 ‘‘(B) MEMBERSHIP.—The Secretary, act18 ing through the Director of the Centers for Dis19 ease Control and Prevention, shall appoint to 

20 the advisory committee under subparagraph (A) 

21 such members as deemed necessary to properly 

22 advise the Secretary, and shall include organi23 zations and individuals with expertise in breast 

24 cancer prevention, diagnosis, genetic screening 


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1 and counseling, treatment, and rehabilitation in 

2 young women. 

3 ‘‘(b) HEALTH CARE PROFESSIONAL EDUCATION

4 CAMPAIGN.— 

5 ‘‘(1) IN GENERAL.—The Secretary, acting 

6 through the Director of the Centers for Disease 

7 Control and Prevention, and in consultation with the 

8 Administrator of the Health Resources and Services 

9 Administration, shall conduct an education cam10 paign to increase awareness among physicians and 

11 other health care professionals— 

12 ‘‘(A) relating to the risk factors, risk re13 duction strategies, early diagnosis and treat14 ment of breast cancer in young women; 

15 ‘‘(B) on when to refer patients to a health 

16 care provider with genetics expertise; and 

17 ‘‘(C) on how to provide counseling that ad18 dresses long-term survivorship and health con19 cerns of young women diagnosed with breast 

20 cancer. 

21 ‘‘(2) MATERIALS.—The education campaign 

22 under paragraph (1) may include the distribution of 

23 print, video, and Web-based materials on assisting 

24 physicians and other health care professionals in— 


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1 ‘‘(A) identifying generally the risk factors 

2 and early warning signs and symptoms of 

3 breast cancer specific to women under the age 

4 of 40 and the specific risk factors that would 

5 require increased monitoring; 

6 ‘‘(B) counseling patients on the benefits of 

7 evidence based healthy lifestyles which reduce 

8 the risks of breast cancer; 

9 ‘‘(C) counseling patients on the importance 

10 of consistent breast self exams to facilitate 

11 breast self awareness and teaching patients how 

12 to perform such exams; 

13 ‘‘(D) understanding the importance of 

14 early diagnosis, including teaching young 

15 women the symptoms of breast cancer and early 

16 detection practices, including clinical breast 

17 exams, blood component analysis, genetic coun18 seling and testing where appropriate, and other 

19 strategies determined to be appropriate by the 

20 Secretary; and 

21 ‘‘(E) the unique long-term effects faced by 

22 young women with breast cancer that will need 

23 to be addressed over their lifetimes, including— 

24 ‘‘(i) re-entry into the workforce or 

25 school; 


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1 ‘‘(ii) infertility as a result of treat2 ment; 

3 ‘‘(iii) neuro-cognitive effects; 

4 ‘‘(iv) important effects of cardiac, vas5 cular, muscle, and skeletal complications; 

6 and 

7 ‘‘(v) secondary malignancies. 

8 ‘‘(c) PREVENTION RESEARCH ACTIVITIES.—The Sec9 retary, acting through the Director of the Centers for Dis10 ease Control and Prevention, shall conduct prevention re11 search on breast cancer in younger women, including the 

12 following: 

13 ‘‘(1) Behavioral and other research on the im14 pact of breast cancer diagnosis on young women. 

15 ‘‘(2) Formative research to assist with the de16 velopment of educational messages and information 

17 for the public, targeted populations, and their fami18 lies about breast cancer. 

19 ‘‘(3) Surveys of physician and public knowledge, 

20 attitudes, and practices about breast cancer preven21 tion and control in high-risk populations. 

22 ‘‘(d) SUPPORT FOR YOUNG WOMEN DIAGNOSED

23 WITH BREAST CANCER.— 

24 ‘‘(1) IN GENERAL.—The Secretary shall award 

25 grants to organizations and institutions to provide 


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1 health information from credible sources and sub2 stantive assistance directed to young women diag3 nosed with breast cancer on— 

4 ‘‘(A) education and counseling regarding 

5 fertility preservation; 

6 ‘‘(B) support, including social, emotional, 

7 psychosocial, financial, lifestyle, and caregiver 

8 support; 

9 ‘‘(C) familial risk factors; and 

10 ‘‘(D) risk reduction strategies to reduce re11 currence or metastasis. 

12 ‘‘(2) PRIORITY.—In making grants under para13 graph (1), the Secretary shall give priority to appli14 cants that deal specifically with young women and 

15 breast cancer. 

16 ‘‘(e) NO DUPLICATION OF EFFORT.—In conducting 

17 an education campaign or other program under sub18 sections (a), (b), (c), or (d), the Secretary shall avoid du19 plicating other existing Federal breast cancer education 

20 efforts. 

21 ‘‘(f) MEASUREMENT; REPORTING.—The Secretary, 

22 acting through the Director of the Centers for Disease 

23 Control and Prevention, shall— 

24 ‘‘(1) measure young women’s awareness regard25 ing breast cancer, including knowledge of specific 


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1 risk factors and early warning signs, and young 

2 women’s proactive efforts at early detection, includ3 ing seeking out information on risk-reducing lifestyle 

4 choices, the number or percentage of young women 

5 receiving regular clinical breast exams, the number 

6 or percentage of young women who perform breast 

7 self exams, and the frequency of such exams, before 

8 the implementation of this section; 

9 ‘‘(2) establish quantitative benchmarks to meas10 ure the impact of activities under this section; 

11 ‘‘(3) not less than every 3 years, measure the 

12 impact of such activities; and 

13 ‘‘(4) submit reports to the Congress on the re14 sults of such measurements. 

15 ‘‘(g) DEFINITIONS.—In this section— 

16 ‘‘(1) the term ‘State’ means each of the several 

17 States, the District of Columbia, the Commonwealth 

18 of Puerto Rico, American Samoa, Guam, the Com19 monwealth of the Northern Mariana Islands, and 

20 the United States Virgin Islands; and 

21 ‘‘(2) the term ‘young women’ means women 15 

22 to 39 years of age. 

23 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—To 

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1 priated $9,000,000 for each of the fiscal years 2010 

2 through 2014.’’. 

Æ 


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