Two things about BreastScreen NSW

@arpie I agree it is morally and ethically wrong that BreastScreen NSW conceals vital health information from women.  It is dereliction of duty, by both BreastScreen NSW and the reading radiologists.
  
The radiologists compromise themselves by agreeing to read scans at a standard that is inferior to BreastScreen WA, private clinics in Australia, and screening programs in overseas jurisdictions.  Thirty-seven (37) states in the USA have legislated that women must be informed of their mammographic breast density, with other modalities recommended to obtain higher quality images of dense breasts. https://densebreast-info.org/

Dense breasts are common in women under 50 (about 50%), but 40% of women in their 50s have dense breasts and  25% of women in their 60s.  BreastScreen NSW actively promotes screening from age 50 and 40% of their 50-60 year-old clients will have dense breasts.  This is a sizeable subset of clients with dense breasts whom BreastScreen NSW is failing by not deploying the modalities that can generate better images and detect cancer at earlier stages.  Their clients are unaware of the risks this poses to their health, prognosis, and treatment regimens when a detection is delayed because BreastScreen NSW 'doesn't do dense breasts' (as I was told by a staff member).

BreastScreen NSW's current marketing campaign includes the claim their 2D mammograms 'can find cancers as small as a grain of rice'.  It is unrealistic that a tumour as small as a grain of rice would be detected in a dense breast under BreastScreen NSW's current substandard reading policies.  The claim is misleading and creates a false sense of security.

That’s awesome, @Maryn .... I am so pleased that your experience with them was a good one, as are many people's.

I reckon 80%+ of people attending Breast Screen Scanning in Australia have had exceptional service and outcomes, which is just terrific.  Sadly, it is the 20% that they are ignoring and deliberately misleading, that may go on to have an adverse diagnoses .. and may even pay with their life.

But when they knowingly withhold vital diagnosis information from their client, putting their lives at risk, the gloves come off!

It is no skin off their nose to advise women of their Breast Density, maybe even giving them a piece of paper with correct options for them to consider - if the patient doesn't follow thru on it, so be it ...BUT ..... it is both morally and ethically wrong NOT to advise them that they have an adverse risk that they are totally unaware of!  

The really sad thing is that most of the women with dense breast tissue (if you look at the films, it shows white around the whole front area of breast including the nipple area) - and that is where Invasive Lobular Cancer is usually found. Invasive (ie aggressive) Lobular Cancer does not present as a 'lump' as such as Ductal and other BCs do - it can also present as 'strands' (not unlike that TV Advert showing the cancer with legs infiltrating everywhere .....) It is always one of the more difficult to diagnose both manually and by mammogram. 

Personally - I will never be trusting a rural bus Breast Screening again .... 

I can’t speak highly enough about the exceptional service I received from Breast Screen SA.
For me they were efficient, kind and thorough- this included all staff present when I had my scans, biopsy,
and diagnosis.
Short of sounding dramatic they had a pivotal role in saving my life ☺️

Here is the account of my run in with BSNSW, following my missed cancer in their mammogram buses in Regional NSW.  The bus is here again, as I type .... probably still not advising women of their breast density and still using inefficient 2D machines :( 

it is a bit of a read, but has lots of valuable information from many of our members.  

I never did hear back from them about comparing ‘their’ films with the radiology films and ultrasound - so can only assume they didn’t do it!

https://onlinenetwork.bcna.org.au/discussion/20505/so-i-received-a-breastscreen-nsw-reminder-for-my-2-yearly-mammogram/p1

It's awful to read these comments knowing that there are people who are suffering needlessly.  I count myself one of the fortunate ones as without the skill of the radiologist at Breastscreen SA who picked up a very hard to see anomaly, I would be in a very different situation now as I had a fairly fast-growing cancer without any symptoms.  That said, because they neglected to send my original scans to the private pathology clinic, my first year scan was absolutely traumatic.  

Breast Screen, in general, is a fabulous idea which has probably saved countless lives but the funding models behind it are flawed.
I've been fighting for years to have their referral models for regional and remote patients overhauled. Long story short, they still refuse to inform call back screens to the closest facility. I still have conversations with women and men who are told that their follow up screen (if any abnormality has been detected) has to be conducted at a Breast Screen facility. That results in stress ridden and completely unnecessary trips to Melbourne when they could just go in to their local facility for a screen. It's all about the money and it sucks. Mxx

It is my understanding the majority of radiologists who read 2D screening mammograms for BreastScreen Australia work in private facilities.  To maintain their Medicare-billing privileges and public hospital access they have to ‘do time’ in the public system, hence they participate in BreastScreen Australia. 

This means if Radiologist A reads your 2D screening mammogram at their private facility, and dense breast tissue is impeding their reading, they will assess breast density and recommend a 3D mammogram and/or ultrasound to obtain better images. 

But if Radiologist A reads your 2D screening mammogram at any state or territory BreastScreen facility (except BreastScreen WA) and dense tissue is impeding their reading, they can’t say anything.  BreastScreen Australia has bought their silence. 

The radiologists are placed in a compromising position because BreastScreen Australia (with the exception of the innovative, cutting-edge BreastScreen WA) requires them to practise at a standard lower than their private facilities.

A detection of breast cancer that is delayed because of low-quality images increases the risk of a woman enduring more aggressive treatment and a worse prognosis.

@arpie Well said.  Your lousy experience is another indictment against the BreastScreen program, with the exception being WA's superior service.

I've had numerous run-ins with BSNSW, in writing - since my own breast cancer was not picked up by the rural buses with 2D machines .... but my GP easily found it 4 months after in a random breast check.   

BSNSW asked if I wanted my films 're-examined' by an independent radiologist & also compared to the ones done at a proper radiologist place.  I said yes.  They then sent me a gleeful letter saying that in their opinion, I didn't have breast cancer.   WRONG ANSWER!  1) they didn't use an independent radiologist to read it & 2) they didn't compare it to the other films.

They got yet another blast from me in writing about the insensitivity of their letter and that it is medical neglect by omission to NOT advise women of their breast density on their very first mammogram & the need for an ultrasound (as a minimum) if found to be the case.

It is illogical that BSWA can tell their clients but BSNSW (or the other states) can't - as they are all under the BS Australia umbrella.

@wendy55 - I am so sorry to hear of your battle with them & it is disgusting that the doctors all protect each other .... xx

@Blossom1961 - I am so sorry to hear of your Dad's malpractise as well.  xx

It costs them NOTHING to advise patients of their breast density - it is their JOB to find the breast cancers as early as they can, and by not advising clients of their basic rights - are contributing to higher mortality rates.

The medical profession will always back each other up. My Dad died of bowel cancer due to a doctor stuff up but we were told not to bother trying to bring them to account because we would lose our home over it. Dad's files were missing for two weeks between the time we requested them and the time we received them.