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Should We Be Told If Our Breasts Are ‘Dense’?

Shouldn’t we all know the status of our own breasts?

Many women will know that having dense breasts, while not considered abnormal or a disease, can be a risk factor when it comes to breast cancer. It can also reduce the visibility of breast cancers during a mammogram scan.

Now, women in South Australia will be informed if their mammogram shows they have dense breasts, a notification only offered in one other Australian state, Western Australia.

The decision followed a six-month trial carried out by BreastScreen SA, where women were told of their breast density and then given follow up information. It was found that it was better for women to have all the information.

“With this research, we are seeking to understand what women may already know about breast density and if they would like to be informed of their breast density as part of regular screening mammograms in the future,” BreastScreen SA clinical director Associate Professor Reintals said.

Adding in a later announcement, “We received overwhelming positive feedback and we now get to roll it out statewide.”

(Credit: Image: Getty)

As a part of this new initiative, women will be told what category of breast density they fall into, of which there are four.

  • BI-RADs a (10 per cent of women): Breasts almost entirely fatty tissue
  • BI-RADs b (40 per cent of women): Breasts have scattered areas of fibro-glandular tissue
  • BI-RADs c (40 per cent of women): Breasts are heterogeneously dense. The mix of non-dense and dense tissue may hide small cancers.
  • BI-RADs d (10 per cent of women): Breasts are extremely dense, which can reduce visibility of cancers on mammograms.

Classifications c and d, suggest high breast density.

While South Australia is being applauded on the movement, many doctors are concerned that women across Australia are missing out on this vital information.

Qualified GP and advocate Sandy Minck told 9News, “I feel confused, angry and sad. I think women have the right to know the information.”

She spoke with the RACGP, sharing her story of having dense breasts. Knowing her breast composition, she had been attending a private clinic for annual mammograms and ultrasounds, which may have saved her life.

(Credit: Image: Getty)

A self-funded MRI found suspicious ductal carcinoma in situ, and a further biopsy confirmed a lobular carcinoma in situ. She underwent a mastectomy, alongside the knowledge that she also carried a specific gene mutation that made her susceptible to breast cancer.

“I don’t think I would have been able to achieve this if I had been attending BreastScreen,” she said. “I believe I am in this position today due to my medical knowledge, contacts, and financial stability.”

The Royal Australian and New Zealand College of Radiologists’ (RANZCR) previous statement, reported by the RACGP in March 2023, read, “However, while additional cancers may be found, these tests may also cause harm through false positive results and none has been proven to reduce breast cancer deaths.”

Yet, their website in July 2023 states that their position is being updated.

“RANZCR is in the process of updating the Breast Density Position Statement. Should you require any information on Breast Density Imaging please contact [email protected].”

It appears that there is a lot of controversy surrounding this topic and whether or not it is a useful element to report. However, they do say that knowledge, given in proper consultation and with context, is power.

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