A group of senior Australian researchers from five universities and cancer clinics are so concerned that women are not being warned they have dense breasts when they have a mammogram they are lobbying for change to save lives.

A group of senior Australian researchers who are lobbying to increase awareness about breast density have launched INFORMD.  Key points from their launch statement include:

• Women with higher breast density for their age are more likely to develop breast cancer. High breast density also makes it harder for doctors to detect breast cancer on a mammogram. But Australian women are not routinely tested for and told about their level of breast density when they undergo a mammogram.
• having high breast density can mask or hide the cancer, making early detection more difficult. This is especially important because women whose breast cancers that are found within 24 months of a “clear” mammogram tend to have poorer outcomes.
• Women who have high breast density for their age and body mass index (BMI) have a four to six-times higher risk of developing breast cancer in the future compared to women with low breast density.
• We are a group of breast cancer scientists concerned that Australian women are not being made aware of the significance of breast density in the diagnosis and prevention of breast cancer.
• We would like to see health professionals (including researchers, radiologists, GPs and BreastScreen) begin talking with women about the best way to measure and report breast density.
• “Environmental” factors then can modify breast density over time. This includes having children, which reduces breast density, and taking certain hormone therapies: hormone replacement therapy increases density, while the drug Tamoxifen decreases density.
• Being “breast aware” is important for all women, but particularly women with higher breast density.
• Mammography is the best breast cancer screening test for women aged 50-74 who aren’t showing any symptoms.
• For women aged 40 to 49 and over 75, the research is less clear about the benefits of breast screening.
• Supplemental screening options such as ultrasound and MRI (magnetic resonance imaging) are available for women with high breast density. However, these also have a number of limitations and are not covered by Medicare for this purpose.
• Ultrasound often results in high rates of false positives, indicating that breast cancer is present when it is not.
• MRI does not lead to higher false positives, but it is not a feasible option for a population-based screening program because of the high costs and insufficient MRI resources (equipment and trained staff).
• A further problem is there are few options to reduce breast density once it is detected.  Tamoxifen is a drug used to prevent or treat breast cancer that reduces breast density and breast cancer risk. But it has significant side effects such as hot flashes, vaginal dryness, low libido, mood swings and nausea, which need to be considered on a patient-by-patient basis.
• The long-term goal of our research – in Australia and abroad – is a tailored screening program where women undergo good-quality screening measures based on their levels of breast density and their breast cancer risk.
• First, we need to determine if women with higher breast density would benefit from supplemental screening mentioned above, or annual mammograms.
• We don’t want to scare women that have higher breast density for their age. Rather, we want to inform them about their risk of breast cancer and the additional care they should take until we find treatments that can reduce density and breast cancer risk. Not all women with high breast density will develop breast cancer, but they should be aware that they are at an increased risk.

For more information on breast density, visit the INFORMD website.