Fact: Approximately 10% of women have high breast density, which significantly increases the risk of developing breast cancer and impacts the effectiveness of detecting breast cancer through 2D mammography. Despite this, thousands of Australian women are being denied this important information due to the absence of national reporting standards and a lack of software in publicly funded screening services that can effectively measure breast density.
Western Australia and South Australia routinely notify women of their breast density. Queensland is currently conducting trials, Victoria is expected to report breast density to all clients by early 2025 and New South Wales is planning to report on breast density within the first half of the year. However, other states and territories still lag behind.
Breast Cancer Network Australia (BCNA) is advocating for a unified national approach to reporting breast density through Australia's national population-based breast screening program – BreastScreen, emphasising the importance of a woman's right to know!
Vicki Durston, BCNA's Director of Policy, Advocacy and Support Services, says Australia's approach to population-based screening is not keeping pace with growing evidence that supports routine reporting of breast density to empower people to understand and manage their risk of breast cancer.
"Every woman has the right to know and understand her breast cancer risk through standardised breast density reporting. For those identified as high-risk or with high breast density, it is essential that clear options and pathways are available to support early detection and proactive risk management. BCNA is committed to working with BreastScreen Australia to understand how risk-based screening can be implemented consistently across Australia, and we look forward to the outcomes of the review driving this important progress."
Currently, supplemental screening for women with high breast density is not reimbursed, creating barriers for those unable to afford it. In its position statement published in late 2023, the Royal Australian and New Zealand College of Radiologists (RANZCR) recommended mandatory reporting of breast density in both screening and diagnostic settings, including BreastScreen services. BCNA is committed to working with BreastScreen Australia to support women with high breast density and we look forward to the forthcoming recommendations from their revised position on breast density and screening.
Krysty Sullivan had a normal BreastScreen mammogram in 2019 and 11 months later she found a lump that was diagnosed as triple-negative breast cancer. Given her breast density would have masked her breast cancer making it unlikely to be detected in a 2D mammogram if it was there, Ms Sullivan has concerns that her cancer was missed through her routine mammogram screening at BreastScreen.
"When I learned that the 'all clear' mammogram was actually not able to see my cancer due to my highly dense breasts, it really shook my trust in the healthcare system. It was traumatic to find out that I was at an increased risk of breast cancer and that traditional mammograms were less able to detect my cancer but no one had told me. Not knowing this left me vulnerable and delayed my cancer diagnosis and treatment by almost a year. I am hopeful that the updated BreastScreen breast density position statement and the program review will position BreastScreen Australia to better support women like me in the future."
Breast surgeon, Dr Melanie Walker says there is a duty of care to provide all women with as much information as possible about their breast health to ensure they can make informed decisions. "There is an urgent need for consistent breast density reporting and comprehensive risk management strategies across Australia. Women should be informed if they may be at higher risk due to their breast density to allow them the opportunity to have their risk assessed and a personal screening strategy designed."
