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 Ala-
bama, 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. KIL-
PATRICK 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. KIRK-
PATRICK 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. WIL-
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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. WOOL-
SEY, 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 Ar-
izona, Mr. HIMES, Mr. BUYER, Mr. PAYNE, Mr. COSTELLO, Mr. TURN-
ER, 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 aware-
ness of the risks of breast cancer in young women and 
provide support for young women diagnosed with breast 
cancer. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Breast Cancer Edu-
cation and Awareness Requires Learning Young Act of 
2009’’ or ‘‘EARLY Act’’. 
SEC. 2. YOUNG WOMEN’S BREAST CANCER AWARENESS 
AND SUPPORT. 
Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.) is amended by adding at the end the fol-
lowing: 
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‘‘PART S—PROGRAMS RELATING TO BREAST 
CANCER 
‘‘SEC. 399HH. YOUNG WOMEN’S BREAST CANCER AWARE-
NESS AND SUPPORT. 
‘‘(a) PUBLIC EDUCATION CAMPAIGN.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall conduct a national evi-
dence-based education campaign— 
‘‘(A) to increase public awareness regard-
ing the threats posed by breast cancer to young 
women of all ethnic and cultural backgrounds, 
including the particular risks faced by certain 
ethnic and cultural groups; and 
‘‘(B) focusing on awareness of risk factors 
of breast cancer among young women and 
achieving early detection of breast cancer 
among young women through community-cen-
tered informational forums, public service ad-
vertisements, and media campaigns. 
‘‘(2) AUTHORIZED ACTIVITIES.—In conducting 
the education campaign under paragraph (1), the 
Secretary may— 
‘‘(A) make public announcements targeted 
towards young women with the goal of edu-
cating them that breast cancer occurs in young 
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women and the steps they can take to recognize 
their individual risk factors and ensure early 
detection of breast cancer, ensuring that such 
messaging is age-appropriate; 
‘‘(B) provide education, through written 
materials, identifying evidence based methods to 
lower the risk of breast cancer in young women 
through changes in lifestyle including diet, exer-
cise, and environmental factors; 
‘‘(C) conduct other activities determined by 
the Secretary to promote educational aware-
ness, early detection, and risk-reducing prac-
tices among young women and increase the 
number of young women with breast cancer 
warning signs who seek immediate care; 
‘‘(D) award grants, contracts, or coopera-
tive agreements to appropriate State agencies 
to carry out secondary school and university 
education campaigns, focusing on breast cancer 
awareness among young women; 
‘‘(E) develop and distribute to young 
women, physicians, and other appropriate 
health care professionals, educational mate-
rials— 
‘‘(i) designed for young women; 
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‘‘(ii) relating to particular risk factors 
for breast cancer in women under the age 
of 40; 
‘‘(iii) identifying methods for increas-
ing early detection, including clinical 
breast exams, blood component analysis, 
and where there is a increased risk of 
breast cancer due to ethnic background, 
genetic mutations, or other risk factors, 
other predictive tools such as genetic coun-
seling and testing; 
‘‘(iv) identifying methods for increas-
ing self awareness, including breast self 
exams, learning how to perform such 
exams, and knowing the signs of breast 
malignancies; 
‘‘(v) identifying evidenced based meth-
ods to lower the risk of breast cancer 
through changes in lifestyle, including diet, 
exercise, and environmental factors; 
‘‘(vi) identifying available treatment 
options for breast cancer; and 
‘‘(vii) for young women who have been 
diagnosed with breast cancer, health infor-
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mation from credible sources that provides 
information on— 
‘‘(I) fertility preservation; 
‘‘(II) support, including social, 
emotional, psychosocial, financial, life-
style, and caregiver support; 
‘‘(III) familial risk factors; and 
‘‘(IV) risk reduction strategies to 
reduce recurrence or metastasis; and 
‘‘(F) carry out a health education program 
targeted to specific higher-risk populations of 
young women based on race, ethnicity, level of 
acculturation, and family history, including the 
African-American and Ashkenazi Jewish popu-
lations under 40 years of age. 
‘‘(3) MEDIA
CAMPAIGN.—In conducting the 
education campaign under paragraph (1), the Sec-
retary shall award grants to entities to establish na-
tional multimedia campaigns oriented to young 
women that— 
‘‘(A) will encourage young women to be 
aware of— 
‘‘(i) their personal risk factors, includ-
ing by talking to their medical practitioner 
about those risks; 
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‘‘(ii) strategies for increasing early de-
tection, including clinical breast exams, 
and where there is a increased risk of 
breast cancer due to ethnic background, 
genetic mutations, or other risk factors, 
other predictive tools such as genetic coun-
seling and testing; 
‘‘(iii) strategies for increasing self 
awareness, including doing breast self 
exams, learning how to perform such 
exams, and knowing the signs of breast 
malignancies; 
‘‘(iv) evidence based preventative life-
style changes, including eating healthily 
and maintaining a healthy weight; and 
‘‘(v) other breast cancer early detec-
tion and risk reduction strategies deter-
mined appropriate by the Secretary; 
‘‘(B) will encourage young women of spe-
cific higher-risk populations based on race, eth-
nicity, level of acculturation, and family history, 
including the African-American and Ashkenazi 
Jewish populations under 40 years of age to 
talk to their medical practitioners about those 
risks and methods for appropriate screening 
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and surveillance, including available genetic 
testing and counseling; and 
‘‘(C) may include advertising through tele-
vision, radio, print media, billboards, posters, 
all forms of existing and emerging social net-
working media, other Internet media, and any 
other media determined appropriate by the Sec-
retary. 
‘‘(4) ADVISORY COMMITTEE.—. 
‘‘(A) ESTABLISHMENT.—Not later than 60 
days after the date of the enactment of this sec-
tion, the Secretary, acting through the Director 
of the Centers for Disease Control and Preven-
tion, shall establish an advisory committee to 
assist in creating and conducting the education 
campaign under paragraph (1). 
‘‘(B) MEMBERSHIP.—The Secretary, act-
ing through the Director of the Centers for Dis-
ease Control and Prevention, shall appoint to 
the advisory committee under subparagraph (A) 
such members as deemed necessary to properly 
advise the Secretary, and shall include organi-
zations and individuals with expertise in breast 
cancer prevention, diagnosis, genetic screening 
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and counseling, treatment, and rehabilitation in 
young women. 
‘‘(b) HEALTH
CARE
PROFESSIONAL
EDUCATION 
CAMPAIGN.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, and in consultation with the 
Administrator of the Health Resources and Services 
Administration, shall conduct an education cam-
paign to increase awareness among physicians and 
other health care professionals— 
‘‘(A) relating to the risk factors, risk re-
duction strategies, early diagnosis and treat-
ment of breast cancer in young women; 
‘‘(B) on when to refer patients to a health 
care provider with genetics expertise; and 
‘‘(C) on how to provide counseling that ad-
dresses long-term survivorship and health con-
cerns of young women diagnosed with breast 
cancer. 
‘‘(2) MATERIALS.—The education campaign 
under paragraph (1) may include the distribution of 
print, video, and Web-based materials on assisting 
physicians and other health care professionals in— 
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‘‘(A) identifying generally the risk factors 
and early warning signs and symptoms of 
breast cancer specific to women under the age 
of 40 and the specific risk factors that would 
require increased monitoring; 
‘‘(B) counseling patients on the benefits of 
evidence based healthy lifestyles which reduce 
the risks of breast cancer; 
‘‘(C) counseling patients on the importance 
of consistent breast self exams to facilitate 
breast self awareness and teaching patients how 
to perform such exams; 
‘‘(D) understanding the importance of 
early 
diagnosis, 
including 
teaching 
young 
women the symptoms of breast cancer and early 
detection practices, including clinical breast 
exams, blood component analysis, genetic coun-
seling and testing where appropriate, and other 
strategies determined to be appropriate by the 
Secretary; and 
‘‘(E) the unique long-term effects faced by 
young women with breast cancer that will need 
to be addressed over their lifetimes, including— 
‘‘(i) re-entry into the workforce or 
school; 
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‘‘(ii) infertility as a result of treat-
ment; 
‘‘(iii) neuro-cognitive effects; 
‘‘(iv) important effects of cardiac, vas-
cular, muscle, and skeletal complications; 
and 
‘‘(v) secondary malignancies. 
‘‘(c) PREVENTION RESEARCH ACTIVITIES.—The Sec-
retary, acting through the Director of the Centers for Dis-
ease Control and Prevention, shall conduct prevention re-
search on breast cancer in younger women, including the 
following: 
‘‘(1) Behavioral and other research on the im-
pact of breast cancer diagnosis on young women. 
‘‘(2) Formative research to assist with the de-
velopment of educational messages and information 
for the public, targeted populations, and their fami-
lies about breast cancer. 
‘‘(3) Surveys of physician and public knowledge, 
attitudes, and practices about breast cancer preven-
tion and control in high-risk populations. 
‘‘(d) SUPPORT
FOR YOUNG WOMEN DIAGNOSED 
WITH BREAST CANCER.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants to organizations and institutions to provide 
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health information from credible sources and sub-
stantive assistance directed to young women diag-
nosed with breast cancer on— 
‘‘(A) education and counseling regarding 
fertility preservation; 
‘‘(B) support, including social, emotional, 
psychosocial, financial, lifestyle, and caregiver 
support; 
‘‘(C) familial risk factors; and 
‘‘(D) risk reduction strategies to reduce re-
currence or metastasis. 
‘‘(2) PRIORITY.—In making grants under para-
graph (1), the Secretary shall give priority to appli-
cants that deal specifically with young women and 
breast cancer. 
‘‘(e) NO DUPLICATION OF EFFORT.—In conducting 
an education campaign or other program under sub-
sections (a), (b), (c), or (d), the Secretary shall avoid du-
plicating other existing Federal breast cancer education 
efforts. 
‘‘(f) MEASUREMENT; REPORTING.—The Secretary, 
acting through the Director of the Centers for Disease 
Control and Prevention, shall— 
‘‘(1) measure young women’s awareness regard-
ing breast cancer, including knowledge of specific 
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risk factors and early warning signs, and young 
women’s proactive efforts at early detection, includ-
ing seeking out information on risk-reducing lifestyle 
choices, the number or percentage of young women 
receiving regular clinical breast exams, the number 
or percentage of young women who perform breast 
self exams, and the frequency of such exams, before 
the implementation of this section; 
‘‘(2) establish quantitative benchmarks to meas-
ure the impact of activities under this section; 
‘‘(3) not less than every 3 years, measure the 
impact of such activities; and 
‘‘(4) submit reports to the Congress on the re-
sults of such measurements. 
‘‘(g) DEFINITIONS.—In this section— 
‘‘(1) the term ‘State’ means each of the several 
States, the District of Columbia, the Commonwealth 
of Puerto Rico, American Samoa, Guam, the Com-
monwealth of the Northern Mariana Islands, and 
the United States Virgin Islands; and 
‘‘(2) the term ‘young women’ means women 15 
to 39 years of age. 
‘‘(h) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
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priated $9,000,000 for each of the fiscal years 2010 
through 2014.’’. 
Æ 
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