Women, know your breast density
WOMEN undergoing mammography (breast x-rays) should ask and be entitled to know what category of breast density they have.
This information is now usually available for anyone using private diagnostic mammogram services, but this is not the case for public screening services.
Past president of the Australasian Society of Breast Physicians, Dr Deborah Pfeiffer, said Australia isn't addressing this issue with the same enthusiasm as the USA which has made breast density reporting mandatory in many states.
"We have a very, very good national breast screening program, but I think the omission of breast density information is lacking," Dr Pfeiffer said.
She said being aware of breast density is especially important for women aged 40 to 60 who have high to extremely high breast density which can make it more difficult for breast cancer to be detected at an early stage.
"Screening mammography is usually more than adequate for women who have low to medium density breasts," Dr Pfeiffer said.
"However, for women with very high density breasts, mammography can be misleadingly normal; you can get a normal report, but you can't say with confidence there is no breast cancer there.
"For women who have extremely dense breast tissue which is usually categorised at 75% to 100%, it may be worth asking what is your breast density and should you have supplemental screening."
Breast tissue density levels are assigned to one of four categories - very low, low, medium and high.
"It can be identified subjectively or with the use of computer-aided diagnostics which outputs a figure of somewhere between zero and 100%," Dr Pfeiffer said.
She said reporting in Australia is optional, however, in the last five years private service provider diagnostic mammogram reports have progressively included a comment about breast density.
For anyone having a public service diagnostic mammogram, Dr Pfeiffer recommends the woman ask the radiographer to comment on her breast density category.
"Breast density doesn't increase over time so if you have been assured you have low to medium density, you don't need to be concerned," Dr Pfeiffer said.
"If you have extremely high density then you should ask every time if the breast tissue is still dense."
These women should also have an annual clinical breast examination by their GP and an ultrasound either immediately after the mammogram or in the year between.
"Certainly, if any woman develops symptoms such as a lump, she shouldn't wait to the next test," Dr Pfeiffer said.