The road ahead for breast density awareness

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The road ahead for breast density awareness

by John R. Fischer , Staff Reporter
From the July 2019 issue of DOTmed HealthCare Business News magazine

For those fighting for better diagnostics and treatment of breast cancer, February 15, 2019 was a day of victory. That was the day the U.S. approved a federal law requiring the inclusion of breast density reporting language within mammography reports to convey to patients and their physicians the status of a woman’s breast density, the risks associated with it, and information on additional screening options.

“This change will have a tremendous impact on women’s healthcare, allowing women to know if they’re at higher risk for breast cancer and potentially leading to earlier detection,” U.S. Senator Dianne Feinstein (D.-CA), a sponsor of the bill behind the law, told HCB News. “Too many women were told they have a clean bill of health following a mammogram, only to later find that dense breast tissue made a tumor difficult to see. Women will now be fully informed of their breast density and whether they should talk to their doctor about additional screening.”

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While 2D and 3D mammography do a good job detecting cancer in fatty tissue, dense tissue can mask tumors, allowing cancer to go undetected and spread to other parts of the body. Knowing about breast density empowers patients to take a more proactive role in their care, and potentially pursuing secondary screening to rule out any diagnostic uncertainty.

Over the last decade, the majority of states have enacted their own laws around breast density reporting, but such laws vary in the context of the information they convey. “Some only provide general notification about breast density,” said JoAnn Pushkin, executive director of educational resource group, “Others tell the women if she is generically ‘dense’, and others provide her actual density category. Some don’t mention density increases risk, and others don’t mention supplemental screening.”

The result is varying levels of understanding among patients, depending on the state they reside in. The new law, however, will relay the same information to patients in every U.S. state and territory, with the FDA developing density reporting language that will notify women of their breast density status, and encourage those at high-risk to communicate with their doctors about the next steps they should take.

Developing this language, though, is not the only task necessary for properly informing patients of breast density. Experts also point to the need for educating healthcare professionals on how to effectively communicate this information to patients, facilitating affordable access to supplemental testing, and conducting risk stratification and breast imaging in more personalized fashions.
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