The Royal Australian and New Zealand College of Radiologists (RANZCR) has updated its position on breast density reporting, recommending that all individuals attending mammography in Australia and New Zealand be notified of their breast density. The updated Breast Density Position Statement reads,
“Whilst a future risk-based model for breast cancer screening is being developed, RANZCR recommends mandating the reporting of breast density in both screening and diagnostic settings in Australia and New Zealand.” Accompanying recommendations include the importance of being breast aware, regardless of one’s breast density, and to consider all potential risk factors for breast cancer in combination. The Breast Density Position Statement also recommends validated tools to assess individual risk such as iPrevent and IBIS. The IBIS tool includes breast density in its risk assessment, iPrevent does not. The Breast Density Position Statement also stresses that “RANZCR supports discussion and collaboration between a patient and their healthcare team to encourage shared decision making.” InforMD's Prof John Hopper spoke to Bridget Judd at the ABC about why breast density matters in the detection and risk of breast cancer.
High breast density appears as white areas on a mammogram. As cancers also show up white on a mammogram, density can mask breast cancer. Because of this, breast density can be used as "a predictor of what we call the interval cancer", explained Prof Hopper. "That's when you have a mammogram and you're given the all clear, and then in the interval before the next screen, the woman has a lump or whatever and it's diagnosed as a cancer," he said. "They tend to be nastier than screen-detected cancers." Prof Hopper also explained about the risk of developing breast cancer in women with high density, and highlighted that with advancements in testing, high density is found to only "really a problem" in about the "very extreme" one per cent. "My analogy is driving a car with faulty brakes — if you leave and the weather's fine and there's not much traffic around, you can get away with it," he said. "But once something starts to happen that puts you at risk, such as your environment changes or your underlying risk factors change because of bad weather and things like that, suddenly having faulty brakes is a real problem." Dr Sandy Minck, Dr Alia Kaderbhai and Kirsten Pilatti, CEO of Breast Cancer Network Australia were also interviewed. "Women who are concerned about about their breast cancer risk should chat to their GP about their breast cancer risk as a whole and the topic of breast density can come into that," said Dr Kaderbhai. Read the full article here. INFORMD's A/Prof Wendy Ingman spoke to Mariella Attard about new U.S. research study suggesting that premenopausal women with a strong family history of breast cancer are more likely to have dense breasts. Read the full article here.
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