I’m currently away on a Family Holiday and much needed recuperation after my Prophylactic Mastectomy and other health complications.
Yesterday The Health Service Executive issued a Publication in relation to Breast Cancer Risk Factors. I’ve been asked to comment, but this week is not the time for me to do major work on this. I have however made numerous notes (comments) on the Text compiled in the Publication. These comments are based on evidence and scientific studies. I am an experienced advocate and PPI contributer on the issue of Breast Density and founder of http://www.beingdense.com
Sometimes it’s necessary to get into the nitty gritty, no detail is too small, yet in my opinion, detail is lacking in this Publication. Absence of Evidence is not Evidence of Absence. When it comes down to Breast Cancer Screening in Women with Dense Breasts a Screening Mammogram is simply insufficient and that is the nitty gritty of the matter. Women with Dense Breasts cannot know they have Dense Breasts unless they are told. The devil is in the detail.
This Publication fails to advise Women of European Recommendations (March 2022) The European Society of Breast Imaging EUSOBI calls on ALL providers of Mammography Screening to share BreastDensity information with ALL women being screened. https://link.springer.com/article/10.1007/s00330-022-08617-6
WHY IS THIS CRUCIAL INFORMATION FROM OUR EUROPEAN RADIOLOGY PARTNERS OMITTED FROM THIS NEW PUBLICATION COMPILED BY OUR HEALTH SERVICE EXECUTIVE AND OUR NATIONAL CANCER CONTROL PROGRAMME
BREAST DENSITY is now OFFICIALLY ‘A BREAST CANCER RISK FACTOR’ in Ireland
I have added some additional comments to the Text of The HSE Publication (in brackets)
Breast density is how breast tissue looks on a mammogram ✅
➡️(Breast Density appears as WHITE areas on a Mammogram. Breast Cancer appears as WHITE areas on a Mammogram also. White on White is almost impossible to distinguish – This is referred to as Masking and is why Breast Cancer can be missed on a Mammogram and is why Women with Dense Breasts should be Routinely Notified and offered Ultrasound or MRI) ❗
Your breasts are made up of 2 types of tissue – fatty tissue and non-fatty tissue. Dense breasts are breasts that have a high amount of non-fatty tissue✅
➡️(Category C and D) are routinely considered to be Dense Breasts)❗
Not all women with Dense Breasts will get Breast cancer. But women with Dense breasts have a higher risk. We don’t know why this is But the more dense your breasts are, the higher your risk✅
➡️(Have a higher risk of what)❓
➡️(Women with Densebreasts, Category C and D have a higher risk of having Cancer missed on their Screening Mammogram, because of Masking)❗
Having dense breasts does not mean you are less likely to survive breast cancer✅ ❓
➡️(If you do develop Breast Cancer
Early Detection is crucial to outcome and less toxic treatment protocols and surgical interventions)❗
➡️(Late Diagnosis of Node Positive Breast Cancers result in harsher treatment, Chemotherapy and more radical Surgery, Mastectomies and Axillary Node Clearance)❗
➡️ NOTE❗
(BREAST DENSITY IS AN INDEPENDENT RISK FACTOR FOR DEVELOPING BREAST CANCER) This fact is omitted from the publication
Who is more likely to have dense breasts
You’re usually more likely to have dense breasts if you: have a low body mass index (BMI)
are under 50 years of age
are pregnant or breastfeeding
are taking hormone replacement therapy (HRT The density of your breasts can change over time. Younger women tend to have denser breasts. As you get older, your breasts become less dense.✅ ❓
➡️(Almost 50% of all Women have Dense Breasts
If you have Dense Breasts at age 50 –
when BreastCheck Screening routinely begins for Women – You are likely to retain your Density going Forward)❗
(Hereditary Factor assoc with Density)❗
How to tell if you have dense breasts
You cannot tell dense breasts by look or feel. ✅
But a doctor can tell if you have dense breasts by looking at a mammogram❗ ❓
(A Radiologist is the person qualified to read your Mammogram – not a GP)❗
It is hard to measure exactly how dense your breasts are. This is because there’s no agreed way of measuring breast density in Ireland❓
➡️WHY NOT❓It’s a Very Visual Finding
➡️(The BI-RADS Scoring System was developed by The American College of Radiologists to enable Breast Density assessment
The BI-RADS atlas provides standardized breast imaging terminology, report organization, assessment structure and a classification system for mammography, ultrasound and MRI of the breast. BI-RADS reporting enables radiologists to communicate results to the referring physician clearly and consistently, with a final assessment and specific management recommendations. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/Bi-Rads) ❗
Talk to your GP if you think you need a mammogram to check if you have dense breasts. ❓ They will also think about other factors, like your age and any family history of cancer.
➡️(Many, many Women have had considerable difficulty with this because GPs are not equipped to assess Breast Density. It is a Radiological Finding and assessed by Radiologists when they are reading your Mammogram) ❗
➡️(Please use our Breast Density Request Form https://acrobat.adobe.com/link/review?uri=urn:aaid:scds:US:7c8e1f72-d120-44bc-93ca-4232a8e0cdb2
It’s in a Printable PDF format and when you complete it, it will have all the relevant information for you and your Radiology Reader Assessment, including Scientific References. Submit a completed Request Form to your GP for your medical records and Submit a copy to BreastCheck if you are 50 or over and when you have a Screening Mammogram) ✅
Screening and breast density
Screening is not routinely performed in women under 50 years.✅❓
where is Breast Density Screening routinely performed IN IRELAND ❓
Dense breast tissue (non-fatty tissue) looks solid and white on a mammogram (X-ray). You cannot see through it. This makes the mammogram more difficult to read.✅
➡️(This is PRECISELY WHY Women who are determined (by the Radiologist reading their Mammogram) to have Dense Breasts, should be APPROPRIATELY NOTIFIED BY THEIR SCREENING PROGRAMME, ABOUT THE RISKS AND OFFERED ADDITIONAL BREAST SCREENING ULTRASOUND OR MRI ❗
➡️This advice is in line with European Recommendations from EUSOBI The European Society of Breast Imaging https://link.springer.com/article/10.1007/s00330-022-08617-6
EUSOBI thus calls on ALL providers of Mammography Screening to share Breast Density information with All the Women being Screened)❗
➡️WHY IS THIS CRUCIAL INFORMATION FROM OUR EUROPEAN RADIOLOGY PARTNERS OMITTED FROM THIS BRAND NEW PUBLICATION COMPILED BY OUR HEALTH SERVICE EXECUTIVE AND OUR NATIONAL CANCER CONTROL PROGRAMME ❓
Finally the HSE concede ……
It means lumps or areas of abnormal tissue are harder to spot. This is why screening using mammograms is less effective for women with dense breasts.✅
LADIES PLEASE FIND OUT IF YOU HAVE DENSE BREASTS ❗✅✅✅✅✅
WWW.BEINGDENSE.COM
Info@beingdense.com
Being Dense 