The California Breast Density Information Group: A Collaborative Response to the Issues of Breast Density, Breast Cancer Risk, and Breast Density Notification Legislation

Price, Elissa R.; Hargreaves, Jonathan A.; Lipson, Jafi A.; Sickles, Edward A.; Brenner, R. James; Lindfors, Karen K.; Joe, Bonnie N.; Leung, Jessica; Feig, Stephen A.; Bassett, Lawrence W.; Ojeda‐Fournier, Haydee; Daniel, Bruce L.; Kurian, Allison W.; Love, Elyse; Ryan, Lauren; Walgenbach, Donna D.; Ikeda, Debra M.

doi:10.1148/radiology.13131217

Cited by 11 publications

(20 citation statements)

References 40 publications

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“…128 Given the increased advocacy and legislation for breast density notification, it is worthwhile to employ tools that are robust enough for clinical use and devoid of subjectivity for mammographic breast density assessment. Interestingly, Volpara TM and Quantra TM are robust and provide breast density score to the practitioner within 2 minutes after the mammographic procedure.…”

Section: Categorisation Of Breast Composition Using "Quantitative Arementioning

confidence: 99%

Breast composition: Measurement and clinical use

Ekpo¹,

Hogg²,

Highnam³

et al. 2015

Radiography

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Breast density is a measure of the extent of radiodense fibroglandular tissue in the breast. The risk of developing breast cancer and the risk of missing cancer at screening rise with higher breast density. In this paper, the historical background to breast density measurement is outlined and current evidence based practice is explained. The relevance of breast density knowledge to mammographic practice and image interpretation is considered in the light of clinical assessment and notification of mammographic breast density (MBD). The current work also discusses risk stratification for decisionmaking regarding screening frequency and better modalities for earlier detection of breast cancer in the dense breast. Automated volumetric approaches are explained while ultrasound, digital breast tomosynthesis, molecular breast imaging, and magnetic resonance imaging are introduced as valuable adjuncts to digital mammography for imaging the dense breast. The work concludes on the important note that screened women should be notified of their breast density, and such notification should be accompanied with clear and adequate information about breast density and cancer risk, strategies associated with lower MBD, as well as best screening intervals and pathways for women with dense breasts. Adoption of these strategies may be crucial to early detection and treatment of cancer and improving survival from the disease.

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Section: Categorisation Of Breast Composition Using "Quantitative Arementioning

confidence: 99%

Breast composition: Measurement and clinical use

Ekpo¹,

Hogg²,

Highnam³

et al. 2015

Radiography

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“…1 Approximately 50% of women have breast tissue clas-sified as either heterogeneously dense or extremely dense, thus reducing the sensitivity rate of mammography. 2 However, almost entirely fatty breasts may have coalescent areas of dense tissue that can obscure lesions. Therefore, the BI-RADS criteria allow for the overall assessment of breast density to convey the likelihood of having an obscured lesion or "masking" effect.…”

Section: Introductionmentioning

confidence: 99%

“…3,6 However, critics argue that this assessment of risk is an overestimation. 2 The studies compared extremes (ie, dense breasts to fatty breasts) rather than comparing dense breasts to average-density breasts (between scattered fibroglandular and heterogeneously dense tissue). 2 When the risk for breast cancer is expressed relative to average breast density, the risk decreases to 1.2 to 2.1 times higher than the average for heterogeneously dense or extremely dense breasts, respectively.…”

Section: Introductionmentioning

confidence: 99%

Imaging Management of Breast Density, a Controversial Risk Factor for Breast Cancer

et al. 2017

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“…In a recent publication, Price et al 6 discussed the breast density inform laws that have been implemented in several states across the country and reviewed the topic of breast density as a risk factor. The authors agreed that breast density is a risk factor but asserted that it is not a strong one in comparison to other risk factors.…”

mentioning

confidence: 99%

“…It is important to take all factors, such as family history of breast cancer, into consideration when notification of dense breast tissue is provided. Price et al 6 expressed this sentiment in their argument, stressing the importance of basing a decision on pursuing additional testing on all risk factors.…”

mentioning

confidence: 99%

Initial Experience With the New York State Breast Density Inform Law at a Community‐Based Breast Center

Destounis¹,

Arieno²,

Morgan³

2015

J of Ultrasound Medicine

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ammography is the only method of screening that has been shown to reduce breast cancer mortality, with a reduction of approximately 30%. 1 However, the limitations of mammography are well known and include the reduced sensitivity in dense breast tissue, which can be as low as 30% to 48%. 2,3 Detecting cancer in dense breasts has been a challenge to breast imagers; it is an important challenge to overcome, as women with dense breast tissue make up approximately half of the population in women younger than 50 years and approximately one-third in those older than 50 years. 4 Objectives-The purpose of this study was to review our initial experience with the New York State breast density inform law (New York public health law, S2404-C) at our outpatient breast center. We sought to review the findings in patients returning for screening breast sonography after a screening mammogram revealed heterogeneously dense or extremely dense breast tissue.Methods-From January 1, 2013, through May 31, 2014, 102,841 patients who underwent screening mammography were seen at our institution. Of these, 35,153 were determined to have heterogeneously dense breast tissue, and 11,864 were determined to have extremely dense breast tissue. Due to the New York State breast density inform law, these 47,017 patients were notified of their breast density, with 935 patients (2%) returning for 971 screening breast sonographic examinations.Results-Heterogeneously dense breast tissue was noted in 66% of the patients (619), and extremely dense breast tissue was noted in 34% (316). Thirty-one percent of the patients (290) reported no additional risk factors; 68% (635) presented with 1 or more additional risk factors; and 1% (10) were adopted, and the risk status could not be assessed. Twenty-five procedures (2.6%) were performed after screening breast sonography, resulting in 22 benign findings, 1 atypical finding, and 2 malignancies. The overall positive predictive value was 8% (2 of 25), and the overall cancer detection rate was 2.1 per 1000 (2 of 935).Conclusions-Handheld screening breast sonography performed in women with dense breast tissue can aid in the detection of otherwise occult breast cancer, as we found 2 cancers in the study population, with an overall positive predictive value of 8%. The addition of screening sonography in this cohort did lead to an increase in minimally invasive procedures in 2.6%.

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The California Breast Density Information Group: A Collaborative Response to the Issues of Breast Density, Breast Cancer Risk, and Breast Density Notification Legislation

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Cited by 11 publications

References 40 publications

Breast composition: Measurement and clinical use

Breast composition: Measurement and clinical use

Imaging Management of Breast Density, a Controversial Risk Factor for Breast Cancer

Initial Experience With the New York State Breast Density Inform Law at a Community‐Based Breast Center

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