'It's negligence:' Advocates call on Nova Scotia to inform women of breast density in cancer screening
Dense Breasts Canada says women should know their breast density like any health care factor, such as blood pressure or family history.
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Advocates are taking aim at Nova Scotia’s “negligence” around failing to inform women of a breast cancer screening risk factor they say could save lives.
Jennie Dale, co-founder Dense Breasts Canada, said their national organization wrote to health minister Randy Delorey earlier this month asking that breast density be included in the 2018 Task Force Guidelines for Breast Cancer Screening as an indicator of increased risk.
According to the group’s medical advisor, Dr. Paula Gordon of the University of British Columbia who penned the letter, breast density is the percentage of normal fibroglandular (non-fat) tissue that looks white on a mammogram. Since cancer also appears white, Gordon said it’s “difficult or impossible” for radiologists to detect cancer spots in women with dense breasts.
“You’ve got thousands of women getting normal mammogram results, thinking they are fine, when they are walking around with cancer,” Dale said in an interview.
“Early detection is the key to survival … and women with dense breasts are 18 times more likely to have a lump found at a more advanced stage. They are not finding it.”
According to Dale’s calculations, Nova Scotia would have about 100,000 women with dense breasts, 23,000 of whom would the highest level of density (75 per cent and over). If those women were informed of their density, Dale said they could then decide to get supplemental screening like an ultrasound, engage in more vigilant self-checking, and make lifestyle changes to lower their cancer risk.
The hardest part is hearing women with Stage 4 breast cancer who tell Dale if they had known about their breast density and gotten further screening, “I wouldn’t be dying.”
Dale said they’re zeroing in on N.S. after seeing Halifax’s Densitas Inc. received a $565,069 contract from the federal government for DM-Density, a software “that will help health-care specialists provide more accurate assessments of breast density,” according to a press release.
Although Dale said they were at first excited to see this research where women’s results would be recorded, and “this is what we want across Canada,” Nova Scotia still has a policy to not include density information on mammogram results to GP’s.
Members of the screening program told Dale there are no immediate plans to provide the Densitas research to GP’s and patients, she said, but to call back in six months because they are looking into how they might eventually provide family doctors with this information.
“What is so hard about saying ‘The woman’s breast density is Category A, B, C, D? What is so difficult?” Dale said, adding in six other provinces the GP is given breast density information on the mammogram report.
The main reason Dale said she hears from health departments on why women aren’t directly told their breast density is because they don’t want to worry patients unnecessarily with further screening since an ultrasound carries a risk of false positive. However, Dale said studies have shown women would rather have a moment of anxiety early on, instead of finding out later a cancer has been missed.
Dale said she was told Nova Scotian women can access their breast density information, but through what she called a ”cockamamie” two-appointment process with one’s family doctor to request information from the radiologist on breast density, and then return for the results.
“There’s no way we’re going to get women to do this,” Dale said. “It’s negligence. The whole situation makes us so furious.”
When asked about Dense Breast Canada’s letter, and whether the health department had plans to use Densitas to inform women and GP’s of breast density, a spokesperson replied in an email “Breast cancer is a serious issue. The department has received the letter and is looking into it.”