Saturday, December 16, 2023


Written by: Dr. Robert L. Bard  (12/2023)
Edited by: Carmen Regallo-Dewitt

Decades since the advent of breast scanning technology, innovations in non-invasive diagnostic imaging provide new options in the field of early detection.  A mammogram can show how dense your breasts are including how low or high in density. However, over-compression artificially lowers the radiographic density.

 [Image 1] in this standard mammogram, a dense breast is presented side by side. The white shaped “V” that comes down the top center are the pectoral muscles of the chest wall. On the far outside, the white line is the skin outline of the breast. This is the dermal tissue causing the white line viewed enface.  Radiologists always study this for any indication of inflammatory disease of the skin or inflammatory breast cancer, which manifests itself in skin thickening.  Between the center wedge and the skin outline, you will find homogeneous cloudy areas with patchy black spaces within as an example of dense breast tissue. 

Usually, dense breast tissue appears white on a mammogram. We must identify them as one of two forms of breast density; one is called FIBROCYSTIC or fibrous [Image 2] which is homogeneously white. Occasionally you can see a branching of blood vessels, dilated ducts or a streak of fat inside the dense breast tissue. This is the most common type of dense breast tissue and generally seen in the over 40 population.

[Image 3] Another example of a dense breast shows the difference between homogeneous white versus the whitish area. This is filled with dark, wormy looking structures, which are the breast glands called GLANDULAR tissue. This kind secretes milk and its glands are often dilated. Both Fibrous and Glandular may appear similar under a mammogram as highly dense areas, but they look completely different under an ultrasound scan.  

Through ultrasound, we can check for tumors easily through fibrotic dense breasts because it stands out as a black region (or a black hole) within the white area. As shown in Image 3, a black hole could get lost, making it more difficult to image this type of dense breast.  In this case, a solution is the use of elastography [Image 4], which offers visual confirmation as indicated by color data. Elastography can measure tissue density (its hardness or elasticity) within the glandular breast tissue. 

This tissue type is more common in the under-40 age group and is associated with other glandular proliferation such as endometriosis and is reportedly linked to dermal inflammation. In published reports, comparative studies between FIBROUS and GLANDULAR breast tissue studies remain limited.  We are observing (especially in the younger age groups) expanding reviews of these types of tissue density aligned with the rates of breast cancer to confirm the rate of malignancy in tissue alteration from normal.

(Play Video-L) The NY Cancer Resource Alliance gives loving tribute to Dr. Nancy Cappello, co-founder of "Are You Dense" and chief crusader of the mission to bring change to the protocols and standards of Early Detection.   Her organization embarked in a global advocacy project to win legislation for dense breast scanning and to bring awareness to the need for better technologies and imaging interpretation. Today, her loving husband Joe continues her unending fight to save more lives through awareness, advocacy and her crusade for change.  (Also see below to read her full story in our ORG SPOTLIGHT section)

Epigenetic Research Notes: Profiling the Dense Breast Paradigm (part 1)

 Coursework (Part 1) written by: Dr. Roberta Kline

As an Ob-Gyn physician and genomics specialist, I have spent the better part of 10 years translating research in the genomic and gene expression areas into clinically usable information for healthcare professionals. One of the biggest challenges we face when connecting research with patient care is the long delay in the translation process and dissemination of the information. It often takes 10 to 20 years for information (validated findings) that comes out of research to be applied in clinical practice. These delays result in many lost opportunities to provide better care for our patients. This is one of the reasons why I'm really passionate about accelerating this process and making it easier for clinicians and their patients to take advantage of cutting-edge information and new technologies. 


We have known for a very long time that there is an increased risk of breast cancer for women who have dense breasts. Until recently, the research has been lagging in terms of what's the molecular mechanism, why do dense breasts present an increased risk of breast cancer? Without this knowledge, we can’t address the root causes, and are left with a lot of trial and error based on incomplete understanding.  (see complete report)

From an interview with MJ Smith

My personal and professional missions are both in women's health. By day, I work for a breast AI company focused on helping radiologists find breast cancers on mammograms. I chose this path because I believe in advancing causes that support women's health simply because women are core members of our culture and our families. I have had two family members, both maternal aunts, who died of breast cancer, - one at the age of 36, and an the other at the age of 52.

Advocacy for Endometriosis is directly related to my personal journey. Growing up with endometriosis since puberty, I've been to the emergency department probably over 20 times for pain or pelvic pain related conditions. The pain had me flat on my back for days at a time or falling out of bed with pain.  I drove myself to a Planned Parenthood in Minnesota where I grew up and was prescribed birth control to manage it well into my twenties.  Despite the hormonal treatments, I still had a series of episodes. 

Endometriosis is the uterine tissue that grows and implants itself outside of the uterus. Going through that pain is the result of a complex process, resulting in swelling and bleeding inside the interstitial spaces of my body. Women who have endometriosis also often develop painful cysts on their ovaries. 

I think the biggest reason you see women in the ER is pelvic pain. Women with chronic pelvic pain (which is often what endometriosis causes) are underserved by the healthcare community because we're constantly complaining of pelvic pain.  The ER is not where you want treatment because you see a different doctor every time you get admitted. With emergency imaging, you usually get a pelvic ultrasound where cysts can show up and they're quick to assume that you have a cyst, or a cyst has burst and this is why you're uncomfortable.  I think now you can do a pelvic MRI with contrast media- but it's still not enough to offer a definitive diagnosis.  (See complete report)

Decades since the advent of breast scanning technology, innovations in non-invasive diagnostic imaging provide new options in the field of early detection. These technologies directly align with breast density screening (and are part of the Bard Breast Density Diagnostic Program).


ROBERT L. BARD, MD  (Diagnostic Imaging Specialist)
Having paved the way for the study of various cancers both clinically and academically, Dr. Robert Bard co-founded the 9/11 CancerScan program to bring additional diagnostic support to all first responders from Ground Zero. His main practice in midtown, NYC (Bard Diagnostic Imaging- uses the latest in digital Imaging technology has been also used to help guide biopsies and in many cases, even replicate much of the same reports of a clinical invasive biopsy. His most recent program is dedicated to the reporting of mental health diagnostic and innovative solutions including the use of modern neuromagnetic technologies and protocols in his MEDTECH REVIEWS program. 

ROBERTA KLINE, MD (Educational Dir. /Women's Diagnostic Group)
Dr. Kline is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at 

Copyright © 2023- Robert L. Bard, MD & All rights reserved.

Friday, December 8, 2023



By: Alexandra Fiederlein (23)  | Edited by: Dr. Roberta Kline and the ICRS Editorial Team

I belong to the graduate-level age group that continues to witness the increasing numbers of breast cancer cases in our country.  The women in this generation also happens to be the next group that falls prey to being UNDERDIAGNOSED. Insurance companies and the medical community have made little or no action to support or identify the need for women in their 20's and 30's to be approved for  standardized early detection / breast cancer screening.  

From the front-row perspective, younger women are as much at risk of getting cancer. Reports show an uptick in genetic predisposition for breast cancer*, alongside a dangerous attitude of denial. Addressing this calls for widespread education and screening programs in our community as essentials to a life of wellness and prevention.  To subscribe to a regular screening routine at the early stage of womanhood raises awareness and prevention for decades to come.  Perhaps someday, installing breast cancer screening centers in  college campuses may be commonplace and a powerful step toward a national prevention initiative.

Assembled by Dr. Roberta Kline, OBGYN & Co-Editor of Women's Health Digest

Source: CDC (link)

Enclosed is research-based public information by the CDC that widely supports the current reality about new cancers (including breast cancer) in women under 40.  The data used by public health comes from a wide variety of places within our local communities: hospitals, laboratories, doctors' offices – anywhere that a person receives healthcare.

Age-specific rates breast cancer for 2020 (Total for ages 20-39)
Rate of new breast cancers = 27/100,000
Equals 11,368 new cases/42,765,288 women

<20: numbers less than 16 cases for lower age categories, data suppressed
20-24: 1.7/100K; equals 174 new cases/10,239,813 women
25-29: 10.4/100K; equals 1,146 new cases/11,016,549 women
30-34: 30.5/100K; equals 3332 new cases/10,939,868 women
35-39: 63.5/100K; equals 6716 cases/10,569,058 women


Click to download the latest ACS report
Targeting the young working PROFESSIONAL is a major part of our population, where the vast majority tends to put off checkups and screenings because they are just "too busy". Professional women need to value their health above anything else, and therefore the narrative needs to be amplified in that area. We find this problem to be quite prevalent in urban areas with the constant on-the-go culture. Offering local resources and improved access for personal scanning are just some progress driven programs. 

GEN Z is a sensible focus group because these are the women who absolutely must receive routine scanning. We need to advocate for the narrative that age 40 is not the starting age where screening needs to begin- especially since we are now seeing cancer cases in younger ages are growing in numbers. Getting OB/GYN professionals on board is especially important because this is where women are getting their prescriptions. 

We need to educate on the benefits of ultrasound. People need to know HOW it works, WHY it works, and why it holds certain benefits over a mammogram. People need to know that it is SAFE and EFFECTIVE, and this technology can save lives. I think it is especially important to emphasize the option of ultrasound for younger women. Many younger women have dense breasts and don't even know it, putting them at a greater risk (I wouldn't have known if it weren't for all of you!). Ultrasound is obviously a safe and effective screening method for young women. It is also not linked with the stigma/fear of getting a mammogram like many women my age hold (X-Ray exposure, etc.). 

If the drive for EARLIER DETECTION means proactive awareness, may this lead to turning social concern into clinical action.  This includes clinicians joining hands with advocacy groups who recognize the many potential areas for at-risk women in my generation whose lives and safety continue to go unrecognized. And once the count of cancer cases and deaths rise exponentially due to inaction, perhaps then will the medical community find urgency in upgrading the required breast cancer screening age to (finally) include generations like mine.  So say we all! 

*Global Increase in Breast Cancer Incidence: Risk Factors and Preventive Measures, PMC9038417. (NIH)-

This article is sponsored by the educational program of Bard Diagnostic Imaging

WHAT ABOUT IF YOU'RE TOO YOUNG FOR A MAMMOGRAM?   I went to my doctor for a lump I felt in my breast and she gave me a response that set off red flags: "don't worry about it". Being a researcher involved in breast density and breast cancer, I knew that I had to take action; I was fortunate enough to have my breast ultrasound training with Dr. Robert Bard (cancer imaging specialist, NYC) upcoming in the next week. Dr. Bard showed me how to use the ultrasound to help me find two benign tumors in my breasts, and it was there that he reported that I have dense breasts. Had I not taken action in getting screened at the young age of 22, I would have never known that I should be getting screened via ultrasound every 6 months (because having dense breasts puts me at a higher risk for breast cancer), nor would I have known that I had benign breast tumors. 

Cancer Researcher/ Graduate- Molloy Univ.

A major concern is the presence of breast cancer in underserved communities, including those TOO YOUNG FOR A MAMMOGRAM.  Whereby the medical community touts the recommended (and legal/billable status) of getting a mammo scan should be between 40-50, what happens to the many women who do not fit this age criteria?  How would they even know to get checked without the support of their clinicians or an alarm from family history? Decades into the battle against breast cancer, clinicians and the public are much more educated about EARLY DETECTION, PREVENTION and the current protocols and modalities available to save lives.  Recent headlines on DENSE BREAST and the advancements in ULTRASOUND SCANNING supports a major part of this battle. SEE COMPLETE FEATURE

Waterbury celebrated a citywide Pink Out on Thursday, October 26th! Saint Mary’s Hospital Foundation has once again partnered with the City of Waterbury to recognize Breast Cancer Awareness. Waterbury Mayor Neil O’Leary, Saint Mary’s Hospital President, Kim Kalajainen and special guest Joe Cappello will address organizers and volunteers from the Waterbury Police and Fire Departments as well as the Education Department, area students and others at 11:00 a.m.  at Waterbury City Hall.  

Video News Release: Innovations in Early Detection

"Are You Dense?" Foundation Co-founder Joe Cappello joins the medical diagnostic community to promote the "Get Checked Now!" campaign. Dr. Robert Bard from the Bard Cancer Center (NYC) supports supplemental imaging including the 3D Doppler Ultrasound scanner to offer dense breast detection.  This video presents some of the latest advancements in ultrasound features to detect tumors through dense breast tissue- reportedly a significant challenge with mammograms. 

According to the American Cancer Society (ACS),  women ages 45 to 54 and post-menopausal years are required to get mammograms every year.[1a] But for the underserved ages (20-40), the risk for breast cancer exists in growing numbers. In support of Breast Cancer Awareness month, the Integrative Cancer Resource Society, the AngioFoundation Institute (501c3) and the "Are You Dense?" Foundation  addresses the continuing concerns for breast cancer in the New York area by recommending early detection screening programs for women over 20 (and not just anyone 40+ as standardized by the insurance companies.

The medical community has identified over 5% of all breast cancer cases occur in women over 20 and under the age of 40. The increased risk for breast cancer in dense tissue also exists and is identified by the medical community.  Diagnostic Imaging specialist Dr. Robert Bard of NYC identifies the need for paying more attention to breast cancer screening to ages younger than the mandated 40+.  "It's about time the (medical) community recognizes the growing rate of breast cancer in women of younger ages... from genetic predisposition to geography to having dense breast tissue, earlier detection should be our next national initiative."

Breast cancer in younger women may be more aggressive and less likely to respond to treatment.

Women who are diagnosed with breast cancer at a younger age are more likely to have genetic mutations predisposing them to breast and other cancers.

Younger women who have breast cancer may ignore the warning signs—such as a breast lump or unusual discharge—because they believe they are too young to get breast cancer. This can lead to a delay in diagnosis and poorer outcomes.

Some healthcare providers may also dismiss breast lumps or other symptoms in young women or adopt a "wait and see" approach.

Breast cancer poses additional challenges for younger women as it can involve issues concerning sexuality, fertility, and pregnancy after breast cancer treatment. [1]

2) INCLUDE SUPPLEMENTAL SCREENING FOR DENSE BREAST TISSUE (WITH HIGH RESOLUTION ULTRASOUND): Women diagnosed with dense breasts should continue to get regular screening mammograms. But there are additional screening tests that can help doctors detect tumors that may not be identified by conventional mammography or DBT. [2]  Any woman who has dense breasts may want to consider supplemental screening, usually with breast ultrasound. Studies show that screening with ultrasound, in addition to mammography, improves detection of breast cancers in women with dense breasts. [3]

3) WHOLE BODY MRI (NO CONTRAST) FOR CANCER SCANNING: In simplistic terms, having a full-body access comports to the fact that everything is connected in one way or another.  Our full-body MRI provides early diagnosis and the largest view of the body, where finding any cancers in the body and/or where they may spread can provide the best chance of treatment success.  In suspected cases of early breast malignancy, the exclusion of metastatic disease is clinically vital and emotionally supportive.

1a) "Infographic: 7 Things to Know About Getting a Mammogram"- ACA/American Cancer Society:,choose%20to%20continue%20yearly%20mammograms.

1) "Breast Cancer in Young Women"- Cleveland Clinic:

2)  "What additional breast cancer screening tests are available for women who have dense breasts?"- Yale medicine-,(whole%2Dbreast%20ultrasound).

3) Columbia Doctors/ "What Are Dense Breasts? A radiologist offers guidance":-Health Insights: October 14, 2022,in%20women%20with%20dense%20breasts.

"In order to catch cancer, you need to be able to detect it at an early stage so we can treat patients with the most effective mechanisms.  Ultrasounds are an easy, cost-effective method for screening for early breast cancers, especially in women below the age of 45, who are likely to have dense breasts. When you are young and premenopausal your breasts are dense and we know that breast density is linked to cancer and which also makes it harder for cancers to be seen on a mammogram. Although breast cancer is rare in women under the age of 40, early detection is key.  Public health campaigns are spending so much money on mammograms for this population of women who can easily and cost effectively be screened using an ultrasound."

"I LOVE this new program! Early detection is essential! There is a stigmatization around mammograms that they are painful and frightening. There is anxiety while you wait for the results. And, don't forget the appointment scheduling hassle.  Women, particularly younger women with active lives, small children, careers don't want to have to fit one more thing into their hectic and demanding schedules. However, mammogram technology itself has advanced and it no longer has to be a painful experience. Clinics and imaging centers are offering untraditional scheduling opportunities, such as very early morning appointments to late evening appointments that are timed for very minimal wait times. And, clinicians are often prioritizing mammogram interpretations so the results are back within 24 hours. The Self Care message is trending right now. Mammograms should be a part of self care."

Epigenetic Research Notes: Profiling the Dense Breast Paradigm (part 1)

 Coursework (Part 1) written by: Dr. Roberta Kline

As an Ob-Gyn physician and genomics specialist, I have spent the better part of 10 years translating research in the genomic and gene expression areas into clinically usable information for healthcare professionals. One of the biggest challenges we face when connecting research with patient care is the long delay in the translation process and dissemination of the information. It often takes 10 to 20 years for information (validated findings) that comes out of research to be applied in clinical practice. These delays result in many lost opportunities to provide better care for our patients. This is one of the reasons why I'm really passionate about accelerating this process and making it easier for clinicians and their patients to take advantage of cutting-edge information and new technologies. 

We have known for a very long time that there is an increased risk of breast cancer for women who have dense breasts. Until recently, the research has been lagging in terms of what's the molecular mechanism, why do dense breasts present an increased risk of breast cancer? Without this knowledge, we can’t address the root causes, and are left with a lot of trial and error based on incomplete understanding. 

It's very encouraging to know that currently there are 124 clinical trials ongoing looking at dense breasts and the relationship with breast cancer, anywhere from improved diagnostics, to treatment, to prevention, and, what’s close to my heart, to understanding the molecular mechanisms - what's happening at the cell level, at the genetic level that is causing different women to have an elevated risk of breast cancer. 

One of the striking features that we're learning about dense breasts and what is creating that density is the microenvironment, which means the environment in the supporting tissue surrounding the glands. This includes fibroblasts and collagen. It seems that rather than estrogen being the dominant factor, it is inflammation that is creating the increased density of breast tissue. 

What's fascinating to me is that even though we associate estrogen with the primary means by which women develop breast cancer, it may be a different process for breast cancers linked to breast density. Some of the research that has just come out in the last few years is showing us that rather than being hormonally driven, we think what's happening is there is an increase in these inflammatory markers in the tissue that is denser, and this is what can also lead to cancer.

There is clearly a genetic, or hereditary component, because having dense breasts is noted to run in families. But while having dense breasts increases a woman’s risk of breast cancer by up to 4-6x, not all of these women actually get cancer. That means there are other factors that can potentially increase as well as reduce a woman’s risk. This is where genomic research has been a gamechanger in identifying these other factors including for women with inherited genetic mutations, such as BRCA. 

We now know that there are multiple genes in multiple other pathways that can modify a woman’s risk of breast cancer even if she carries a BRCA mutation. [1]. Researchers have identified smaller changes in genes called SNPs (single nucleotide polymorphisms) that have a much lower individual impact than genetic mutations, but together can be additive.[2] In fact, women with specific patterns of SNPs had their risk of breast cancer significantly reduced. This can help explain why not all women with BRCA mutations get cancer, and provides insight into potential protective biological mechanisms.

This is a really powerful paradigm shift, because now it opens the door for truly individualizing each woman’s risk – and potentially being able to change it through diet, lifestyle, or other modalities.

We now are also learning that gene SNPs can also play a role in a woman’s risk for dense breasts and breast cancer. While there's much research that needs to be done, from my experience, there's a lot we can do already to potentially intervene and help women with dense breasts. As we wait for more definitive research, we can learn from the nutritional genomics and functional medicine realms. 

We have long known that pro-inflammatory conditions are underlying drivers for so many of the chronic diseases we see today, from cancer to heart disease, diabetes, autoimmune disease, depression and more. The flip side of inflammation is oxidative stress. They go hand in hand. Some of the genes that drive these processes are now also being linked to dense breasts and potentially the increased breast cancer risk that women with dense breasts have. 

My question is, why can't we use some of these dietary lifestyle and nutritional supplement interventions that we already know decrease many of these pro-inflammatory pathways? Why can't we start using those in clinical practice as we wait for research and clinical trials to better refine our knowledge?  The fact is, we can! But it takes education, awareness and advocacy to implement these strategies more widely and make a difference now.


1) link to polygenic model – breast cancer, Lynch syndrome etc

2) Link to genetics/genomics

2024 CLINICAL PROFILE OF THE DENSE BREAST PARADIGM - for the Obstetrics & Gynecology Society 
Written by: Roberta Kline, MD
Published by ICRS Medical Press Ltd.

Breast cancer affects the lives of hundreds of thousands of women every year and is a leading cause of death.  While we have made great progress in advancing earlier diagnosis and more individualized treatments, we still need to improve our approach to achieve our ultimate goal - prevention. This requires a deeper understanding of the molecular mechanisms and the multitude of factors that contribute to the development of breast cancer.  

Dr. Roberta Kline, recognized speaker and publishing crusader for women's health brings you a comprehensive review and a deep-dive analysis of the current research  findings about breast density and its major risk factors for breast cancer.  Her reports uncover current imaging practices and clinical protocols updated in great support of breast density detection and the means of addressing this growing condition that affects over 45% of the female population. "Knowing a woman has greater breast density is a critical first step, but it doesn’t end there... we need to go further by understanding the causes of breast density, and how they relate to breast cancer-- we now have another avenue to proactively intervene to reduce risk or even prevent breast cancer in the first place."  This textbook is a champion in targeting the Dense Breast Paradigm as a blueprint and a clear course study for all clinical professionals who are dedicated to women's early detection and prevention programs. (More information)

9/27 Is World Dense Breast Tissue Day


PROCLAMATION: 9/27 Is World Dense Breast Tissue Day

9/19/2023- Mr. Joe Cappello, co-founder of the "Are You Dense?" Foundation was invited to attend the Santa Clara County Board of Supervisors meeting at County Government Center to receive an official proclamation by Santa Clara County Supervisor (and former California State Senator) JOE SIMITIAN, officially confirming September 27 as World Dense Breast Tissue Day.  According to Mr. Simitian, this proclamation was sparked by earlier discussions about the late Nancy Cappello who passed away of breast-cancer related complications from dense breast tissue.  "(Nancy's) own life experience... said others should have more power, more knowledge, more ability to affect the decision making in their own healthcare. For this, we are a better state, a better county, and in fact a better nation by virtue of her work."

To date, Joe Cappello continues to build and promote educational programs supporting research, clinical upgrades and improved scanning/monitoring programs.  The "Are You Dense?" Foundation and "Are You Dense?" Advocacy are produced by the Cappellos in pursuit of saving lives through awareness through uniting with community leaders, clinical professionals and public recognition off the continued risks of having dense breast tissue.


County of Santa Clara Board of Supervisors


SPEAKER: Santa Clara County (CA) Supervisor Joe Simitian- District 5

Thank you, Madam President. And I'm going to look to the clerk to see if we can bring Mr. Joe Cappello from “Are You Dense?” in Connecticut up on the screen. 

Colleagues and members of the public, you'll recall of course that just last week, we adjourned our meeting in memory of Nancy Cappello, who passed away almost five years ago now. And it provided an opportunity for our board to reflect on Nancy's extraordinary work over literally decades. We also took the opportunity at our last meeting to express our formal support for the Find It Early Act which is an effort at the national level congressional level to take the next step in terms of addressing the cancer risk of women with dense breast tissue. Today, we are calling out the formal acknowledgement of World Dense Breast Tissue Day. And the reason for that, Joe, and colleagues and members of the public is to ensure that we take advantage of this opportunity to identify September 27th as World Dense Breast Tissue Day, so that members of the public will have the information, the knowledge, the power that Nancy Cappello thought they were entitled to all those years ago.

And as we have discussed previously (so I won't speak at quite substantial length today) this is information that patients need to have. They are now entitled to have it by law.  That entitlement is in large measure, a function of the fact that Nancy Cappello took her own life experience and said others should have more power, more knowledge, more ability  to affect the decision making in their own healthcare. For this, we are a better state, a better county, and in fact a better nation by virtue of her work.  Joe, if you were here, I would have you up to the podium and I would hand you the physical commendation. But by virtue of our virtual connection today, I will virtually present it to you and we will send you the physical commendation and I hope it will find a place at “Are You Dense?”. 

I'm guessing that your screen-... It doesn't reveal it, but I am wearing on my lapel the “Are You Dense?” button which I wore all those years ago when I was privileged to work with Nancy and the organization on California law. With that, Madam President, I say thank you to our board, and to my colleagues for their support on this measure and through the chair. With your permission, I'd like to give Mr. Cappello an opportunity to say a brief word or two.

Guest Speaker: JOE CAPPELLO

Well, thank you, Supervisor Simitian. As I said before, it's a real pleasure. I finally got to meet the other Joe in Nancy's life. And believe me, she always had kind words to say about you, and you were always a standup guy. You were the one that she could count on for honesty and truthfulness when we were doing our legislative work in California.  What we have now is a disclosure law, which is a national law, which will take effect a year from now.  This is huge step for the health of women all over this nation. What it's going to do is standardize (diagnostic care) in the medical field for women with dense breasts. I thank you in the name of Nancy for the proclamation. She deserves it all. She worked hard and worked smart. She was not only prettier than me, <laugh>, but smarter than me. And, I thank you on her behalf. I appreciate that. Thank you.

The Board of Supervisors of the County of Santa Clara, CA regularly meets in the Board of Supervisors’ Chambers, County Government Center, 70 West Hedding Street, San Jose. Regular meetings are held on designated Tuesdays at 9:30 a.m. The Board also holds regular meetings for the purpose of adjourning into Closed Session on Mondays at 2:00 p.m., which may be combined with meetings scheduled for the presentation of ceremonial items to be heard at 4:00 p.m.


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