Forum Discussion
Dr Sandy Minck has advocated for Dense Breast Tissue women to be ADVISED at BreastScreen Level ....
I, personally, believe that all women should be advised of their Breast Density at the time of screening (as they can see it there on the screen) and given documentation on what it may mean (ie having an ultrasound is often more effective in 'finding' tumours in dense breast cancer tissue.) By way of explanation - My own Invasive Lobular Breast Cancer was totally missed by BreastScreen NSW back in 2018 (the lump was found 'accidentally' by my GP just months after a 'clear mammogram'!) ..
After my surgery & radiation, I requested BreastScreen to 're-examine' my previously 'clear' scans - in hindsight of knowing the result ... and it resulted with them almost gleefully telling me that it was NOT breast cancer!! WRONG! Since then, I've had SPIRITED discussions with them, with them still refusing to advise their clients of their INCREASED RISK of a delayed diagnosis and the possibility of a more advanced cancer found 'later'!
Last night, Channel 9 news and a GP Dr Sandy Minck who's had a mastectomy (and who's mother passed away with breast cancer) posted that they want patients to be ADVISED of their breast density when they have routine Breast Cancer Screening - as it is a very real indication of the serious nature that Dense Breast Tissue has, in NOT identifying Breast Cancer ..... as, if not picked up EARLY ENOUGH, the diagnosis can result in a more serious diagnosis later on ... as 'white on white' does NOT show on the screen as a cancer.
An interview with Sandy Minck on the ABC is here:
https://www.abc.net.au/news/health/2023-05-18/breast-density-cancer-screening-explainer/102338008
BreastScreen in WA and South Australia both advise their clients of their breast density at the time of screening - why not all the other states?
After my surgery & radiation, I requested BreastScreen to 're-examine' my previously 'clear' scans - in hindsight of knowing the result ... and it resulted with them almost gleefully telling me that it was NOT breast cancer!! WRONG! Since then, I've had SPIRITED discussions with them, with them still refusing to advise their clients of their INCREASED RISK of a delayed diagnosis and the possibility of a more advanced cancer found 'later'!
Last night, Channel 9 news and a GP Dr Sandy Minck who's had a mastectomy (and who's mother passed away with breast cancer) posted that they want patients to be ADVISED of their breast density when they have routine Breast Cancer Screening - as it is a very real indication of the serious nature that Dense Breast Tissue has, in NOT identifying Breast Cancer ..... as, if not picked up EARLY ENOUGH, the diagnosis can result in a more serious diagnosis later on ... as 'white on white' does NOT show on the screen as a cancer.
An interview with Sandy Minck on the ABC is here:
https://www.abc.net.au/news/health/2023-05-18/breast-density-cancer-screening-explainer/102338008
BreastScreen in WA and South Australia both advise their clients of their breast density at the time of screening - why not all the other states?
The FDA in the US has recently mandated that women be notified by mammogram providers if they have dense breasts, giving them the opportunity to arrange supplemental testing.
But BreastScreen Australia’s 2020 position statement does not recommend the routine recording of breast density or the provision of supplemental testing for women with dense breasts.
A podcast about breast density ....
https://shows.acast.com/63184d1dee39db00126ae2d3/episodes/breast-density
Professor Vivienne Milch, the government’s medical advisor on screening policy, and Professor Bruce Mann, a breast surgeon and researcher, are two of our guests today in the Tea Room (podcast above)
They also talk to two patients about their experiences with breast density and cancer, who find the lack of notification baffling – and a little bit 1950s.
Dr Sandy Minck, a GP by training and a breast cancer survivor, said she was “dumbfounded” by the BSA position statement.
“As a consumer I'm outraged. As a health professional, I'm dumbfounded. I just don't understand it.”
Professor Milch says the program will conduct an evidence review on supplemental screening for women with dense breasts some time this year, although there is no guarantee of a policy change.
“We're aware of the growing momentum of advocacy and of also some women's desire to know their breast density,” Professor Milch says, adding that different states have different policies.
“We may or may not have a policy change. But we'll be looking at the evidence.”
Professor Bruce Mann, who works with the Roadmap to Optimising Screening in Australia (ROSA) project, says there is enough evidence to justify a change to BSA’s screening regimen.
“As women and the community becomes more informed, there is a danger that what is offered by BreastScreen will be seen as insufficient,” he said, which will lead to women opting out of BreastScreen and going private.
“What we don't want in this country is a two-tiered system where those who know and can get the best, do, and everyone else gets what's offered to them. That's what we are working to avoid.
“Western Australia has been telling women about their breast density for some time, and then there are pilots in some services in [Queensland and South Australia].
IF IT IS GOOD ENOUGH FOR THEM, WHY NOT IN THE OTHER STATES AS WELL?
23 Replies
- Make sure you jump onto here & do the Survey!!
Make your views known about Dense Breast Tissue and inadequate advice to those that have it re increased risk of finding a more advanced cancer (even Stage 4 straight up) as the tumours CANNOT be seen on Mammograms. Ultrasound or MRI is needed to identify tumours in Dense breast tissue BE TOLD!! ... Specially for Invasive Lobular, too, which is even MORE difficult to see, even without dense breast tissue!
Public Consultation - BreastScreen Australia Review - Australian Government Department of Health - Citizen Space - Totally agree, @arpie. Keep up the fight!
- Totally agree @arpie. I was never advised I had dense breast tissue and what that actually meant in terms of increased risk. Nor was I advised how to reduce that risk. Bit annoyed at that really. It's our bodies and we should be told these things and what we can do about it to help ourselves.
- This is from an overseas medical report, following a mammogram, where the patient showed dense breast tissue!
This is ALL that BreastScreen Australia has to include ON THEIR REPORT if the MG shows dense breast tissue .... yet they still refuse to advise women of their increased BC risk, due to having dense breast tissue! Only BreastScreen WA and South Australia advise women of their breast density.
IT SHOULD BE ALL STATES!
It really IS NOT GOOD ENOUGH, when something as simple as this, could be included on every woman's report, who is at added risk of finding a later stage BC! - I agree, it’s extremely important.I’m early in my journey, but thankfully my GP didn’t dismiss my vague symptoms & my surgeon was thorough & because I had dense breasts ( young breast tissue is how he worded it, I’m 55) sent me for an MRI after my initial investigations. I had never felt a lump- I’d had altered sensation to a small area on my right breast. Initially I had a mammogram & ultrasound . A small lump was found on u/s & biopsied it was IDC in my right breast. The MRI showed another lump & larger areas of DCIS in both breasts. So instead of just a lumpectomy & radiotherapy as initially thought, I’m now awaiting an appointment with a team in the city for a double mastectomy.I believe it’s vital that appropriate imaging is done.
- @Fufan due to family history, she should be able to have annual screening mammograms at Breastscreen. My sister did after my diagnosis, until her own diagnosis five years later but I don't think she received annual reminders.
However, sometimes, as @arpie said, the convenience of having it all done at one place, on the same day, wins hands down - @arpie the daughter has had hassles with Breastscreen. I think the issue may have been that she wanted the screen ANNUALLY. Just easier to do both tests privately. Pity not everyone has the luxury of affording that! And Breastscreen, of course, will not do our post-cancer checks, so there’s more expense.
- @Fufan BreastScreen NSW can't refuse anyone over 40 and no need for a referral, but radiology places, who would do the US at the same time would charge - so would make more sense to get them both done together .. and may need a referral from her GP xx.
Ultrasounds should be standard procedure for those with dense breast tissue, particularly those using the BreastScreen buses, as they still only use 2D technology - and will still miss many tumours in those with dense breast tissue.
Maybe the newer 3D/Tomosynthesis used in major centres IS 'better than ever' ... but I am not sure I'd only go with that - I'd still ask for the US, even if I had to pay, I reckon!! ;) - She is over 40, @arpie, and lives in Sydney, but I guess would have to argue to get the mammogram. And they won’t routinely do the ultrasound. So she should go private. We can afford it, but that’s not the point: it should be available on a needs basis to EVERYONE!
- I can understand that the US may need to be done privately - but why the Mammogram? Is she in a regional area where the Breastscreen bus doesn't go? I'd be looking into that one!!
If she is 40 and over - it is free with Breastscreen NSW. AND she doesn't need a referral for it - just the US.
