Density Debate: Should we tell the women?
InforMD members Jennifer Stone, Gerda Evans and Wendy Ingman were invited to participate in a debate at the biennial BreastScreen Australia conference in Adelaide 19th-21th April 2018. The topic was “Breast density – Should we tell the women?”
The audience voted yes or no on the question before & after the debate. Both teams argued very persuasively, making the audience’s decision tough. However, the team who argued against density inform won the day with 59% of the vote.
Despite this debate’s results, Pink Hope remains adamant on the belief that breast density should be fully disclosed to a patient. We believe that withholding this information damages a patient’s trust and the full knowledge/assessment of her true risk for breast cancer. It is an obligation of Australian medical practice and could be used as a foundation on which to build a national policy- something that Pink Hope is relentlessly advocating for.
Wendy Ingman, an Associate Professor for breast research at the University of Adelaide, sat on the panel arguing for full disclosure of breast density. Ingman says, “Individuals are the best judge of their own interests. What might be perceived as the correct course of action by the doctor, may not always be right for individual patients and their particular circumstance.”
The crucial inclusion of how dense a woman’s breasts are when she goes for a screening could save her life. At Pink Hope, we believe that breast density is not a “one size fits all” approach. With breast density only detectible on a mammogram, it is up to healthcare providers to make sure that a patient has all information presented in order to make the most informed decisions regarding her personal health. Giving her knowledge, will additionally give her the appropriate decision-making power.
“As outlined by the Australian Commission on Safety and Quality in Health Care, shared decision-making involves the integration of a patient’s values, goals and concerns with the best available evidence about benefits, risks and uncertainties, in order to achieve health care decisions appropriate for the individual,” says Ingman.
The WA Difference
For the past 10 years, BreastScreen WA has notified women if their breast tissue is dense and informed them of the fact that when breasts are dense on a mammogram, it is more difficult to see abnormal changes, including early signs of breast cancer.
A preliminary survey conducted from over 5000 BreastScreen WA participants, revealed that over 70% of women said that knowing they had dense breasts made them feel informed, compared to 22% who said knowing their breast density made them feel anxious and 24% who felt confused. T We accept this confusion, giving us more motivation and desire to create open disclosure with a clear and consistent message.
Through our density hub, we help inform women and healthcare professionals about the risks accompanied with breast density and how to seek proper screening options if you have dense breasts. Without the knowledge that a woman has dense breasts, she could be unaware of the best fit screening options, resulting in missed cancer detection.
We believe every woman has the right to take full control of her health and staying informed is the gateway to changing the future. Without giving women the crucial knowledge of their breast density, we are committing a severe injustice to these at-risk patients.