Breast density - the percentage of fibroglandular tissue - is an important determinant of breast cancer risk, with increasing density increasing risk. In addition, breast density can significantly impair the ability to detect breast cancer. This effect is often called "the perfect storm".
In the screening setting high breast density is responsible for a large percentage of interval cancers. Additional screening modalities can be added to mammography to enhance breast cancer detection in those women with dense breasts.
There is a huge variation across developed nations about the necessity to inform women who are undergoing routine population screening about their breast density.
The measurement of density can be done by the mammography reader (BIRADS 1 to 4 or A,B,C,D). In addition automated, computerised systems have also been developed to assist in the estimation of breast density.
What are our obilgations to inform women undergoing routing mammographic screening about their breast density, knowing that it is a significant risk factor for developing breast cancer and may compromise the accuracy of screening?
What is the current situation in Australian state programs and what are the future plans for BreastScreen Australia? What is happening in overseas programs?