What’s new.

We know the importance of being updated on the latest news and legislation when it comes to breast density and related matters.

Health Care Professionals

Australian updates

In August 2017, Pink Hope commissioned a nationally-representative survey that explored women’s awareness, or lack thereof, regarding breast density, breast cancer risk and screening options available. In total, 1,010 women from all states and territories across Australia completed the online survey.

Results showed that three quarters (79.4%) of women over the age of 50, who were at increased risk of developing breast cancer, didn’t know or were unsure as to whether or not they have dense breasts. In addition, almost two thirds (65.8%) of the 1,010 women surveyed had no idea that breast density can obscure a lesion or lump on a mammogram.

BreastScreen Victoria introduces risk stratification approach.

From 4 Sept 2017 Breast Screen Victoria have introduced a risk stratification approach to screening based on family history. Different screening recommendations will be provided based on three risk categories (average, moderately increased and potentially high risk). However, of note, breast density is not included in this risk stratification approach.

International updates

US legislation.

While in Australia, there is currently no requirement for breast density to be provided on mammogram reports,1 in the USA, 28 (56%) states have adopted a mandatory breast density notification requirement since 2005 and Federal legislation is pending.2,3
For more information on USA legislation, visit the Are you Dense Advocacy website.

1. BreastScreen SA. Breast density Information for consumers. Availabe at: http://www.sahealth.sa.gov.au/wpswcm/connect/6
1a80804e78310ebd28fdc09343dd7f/Breast+Density+Consumer+Information-v3_FORMATTED.pdf?MOD=AJPERES&CACHEID=6e-
1a80804e78310ebd28fdc09343dd7f. Accessed September 2017. 2. American College of Radiology.
Available at: https://www.acr.org/Advocacy/eNews/20170217-Issue/20170217-State-Breast-Density-Reporting-Laws-Proliferate.
Accessed September 2017. 3. Freer PE. Radiographics
2015;35:302–15.

3D mammography approved by FDA.

In June 2017, the FDA approved Hologic’s Genius™ 3D Mammography™ Exam as the only mammogram superior for women with dense breasts.*

*Compared to standard 2D mammography alone.

1. U.S. Food & Drug Administration Premarket Approval (PMA). FDA.gov. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P080003S005.
Accessed November 2017.

Recent publications on breast density and cancer risk

“Knowing this information should prepare practitioners to better identify women who may have not been exposed to breast density messages.”

Santiago-Rivas M et al. Breast density awareness and knowledge, and intentions for breast cancer screening in a diverse sample of women age eligible for mammography. J Cancer Educ 2017 Aug 14. [Epub ahead of print]. Link

“If cumulative breast density is a key determinant of breast cancer risk, younger ages may be the more critical periods for lifestyle modifications aimed at breast density and breast cancer risk reduction.”

Burton A et al. Mammographic density and ageing: A collaborative pooled analysis of crosssectional data from 22 countries worldwide. PLoS Med 2017;14(6):e1002335. Link

“Our results suggest that both absolute dense volume and percentage dense volume are strong markers of breast cancer risk, but that they are even stronger markers for predicting the occurrence of tumors that are not detected during mammography breast cancer screening.”

Wanders JOP et al. The effect of volumetric breast density on the risk of screen-detected and interval breast cancers: a cohort study. Breast Cancer Res 2017;19(1):67 Link

“This article reviews the current evidence regarding the impact of breast density relative to other known risk factors, the evidence regarding supplemental screening for women with dense breasts, supplemental screening options, and recommendations for physicians having shared decision-making discussions with women who have dense breasts.”

Lee CI et al. Risk-based breast cancer screening: implications of breast density. Med Clin North Am 2017;101(4):725–41. Link

“This article reviews the origins and current status of breast density inform laws and strategies for optimal breast density determination. Clinical evidence that dense breast tissue is associated with increased breast cancer risk is presented, together with a review of relative risk compared with other risk factors. Finally, there is in-depth analysis regarding the rationale, benefits, and risks of supplemental screening modalities, including ultrasound, tomosynthesis, and MRI.”

Hooley RJ. Breast density legislation and clinical evidence. Radiol Clin North Am 2017;55(3):513–26. Link

“Breast density was the most prevalent risk factor for both premenopausal and postmenopausal women and had the largest effect on the PARP; 39.3% (95% CI, 36.6%-42.0%) of premenopausal and 26.2% (95% CI, 24.4%-28.0%) of postmenopausal breast cancers could potentially be averted if all women with heterogeneously or extremely dense breasts shifted to scattered fibroglandular breast density.”

Engman NJ et al. Population-attributable risk proportion of clinical risk factors for breast cancer. JAMA Oncol 2017;3(9):1228–36. Link

BE IN THE KNOW

Sign up and become your own breast advocate by staying in the know.