Breast Density Workshop Adelaide papers online

@arpie. In WA Breast Screen advise a client has dense breasts and advise they discuss this with their doctor. I guess is you have a mammogram result that reports negative for breast cancer many do not take the next suggested step.

@arpie which maybe one reason WA’s stance is not widely supported.Of thegrades a-d it is c- d which gives most concern for false negatives.Alsoit would seem many WA people are unaware that breast density may mask breast cancer .

@arpie WA does not advise patients about breast density grade just that the patient has dense breasts.

I invite anyone else present to add to / correct any errata eg @gevans 

I have advised the convenor Wendy Ingman of my observations also  on this thread of the blog and also invite her to add to/ correct any errata.

And then there is the issue of government funding thru the public sector additional testing for those not in private health.

I think legal risk has a lot to with it in the very litigious times we live in .

They don’t seem to have the measurement process defined enough yet.

They use software packages embedded in the equipment to combine volume and area of breast density tissue to measure the grade of breast density.

@arpie the issue is their is different software available to measure breast density and despite a common grading a- d they generate different starting and ending points for each grade.ie what maybe a ‘d’ on one package maybe a ‘c’ on another .

......I had the impression later that the inability to accurately measure breast density across both public and private health systems may be a  contributory factor to the ANZRC lack of support for revealing breast density to patients undergoing mammography. Basically fear of being sued .....

That is really weird, @Romla  - as they already have a grading system!! ..... The diagrams shown on one of the papers pretty clearly showed the difference in the mammogram images of the 'fatty breast' tissue (Type A & B) vs Dense Breast tissue (Types C & D)

 So surely, people having Mammograms who have EITHER of the Dense Breast tissue 'types C or D or 3 & 4' - it is virtually medical negligence to NOT inform them that the mammogram will not be accurate in picking up cancer lesions - as it basically applies to 50% of women being screened!!  That is a HUGE number of women out there, possibly walking around with right now, with a growing cancer in them that COULD have been diagnosed & treated at an early stage, not waiting til they are Stage 3 & 4 or worse!  :( 

(From the BCNA presentation:)

The level of mammographic density can be scored or rated by radiologists along a scale from mostly fatty (very low density) to mostly dense. One of the most commonly used scales is the American College of Radiology’s Breast Imaging Reporting and Data System (BI-RADS), which radiologists use to classify MD on mammograms as A, B, C or D. Sometimes a numerical scale of 1, 2, 3 or 4 is used instead.

• Type A (almost entirely fatty, the lowest density): around 10 percent of women who undergo a mammogram will have mostly fatty, very low-density breasts.
• Type B (scattered areas of fibroglandular density): roughly 40 percent of women who undergo a mammogram will have this low level of density.
• Type C (heterogeneously dense): another 40 percent of women will have this type of mammographic density, which is considered dense and may obscure small masses.
• Type D (extremely dense): around 10 percent of women undergoing a mammogram will have extremely dense breasts, which lowers the sensitivity of mammography.