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World Dense Breast Day!

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On September 28th, we are honored to host the inaugural World Dense Breast Day event to promote education about dense breasts.

Sponsored by DenseBreast-info.org, the day has been added to the National Day Calendar. The purpose of this worldwide 24-hour social media blitz is to raise awareness about dense breasts and share medically sourced educational resources.

For more details about the day:

How you can participate:

Join us in making history as we launch this one-day worldwide education event!

Upcoming EUSOBI Meeting

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EUSOBI:
The EUSOBI Scientific Meeting will take place 29 September – 1 October 2022, in Malmö, Sweden. Members of DB-i/Europe will be in attendance, please stop by!

  • Please visit Cheryl Cruwys, European Education Coordinator, at table C07 on the exhibition floor to learn more about DB-i /Europe and educational tools for both patients and health providers
  • Don’t miss the Oxford Debate, This house believes that women can make an informed choice on screening methods
    • Featuring DB-i European Liaison Dr. Athina Vourtsis, Athens/GR (yes) and Professor Dame Lesley Fallowfield, Sussex/UK (no)
    • Where/When: Malmo Arena Lecture Hall, Friday, 30 September, 12:00  (local time)

Editorial:
DB-i Medical Advisory Board member Dr. Regina Hooley and her colleague Dr. Melissa Durand, comment in an editorial on the study by Chen et al in the UK, and note that mammographic technologists can perform as well as radiologists reading two-dimensional digital mammograms in the setting of a double reading screening program, and “it is reasonable to consider that appropriately trained and experienced physician extenders could have the potential to independently read screening mammograms.”

 

New! Women Can Handle the Truth

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Australia:
The Medical Journal of Australia interviewed DB-i’s Dr. Wendie Berg and JoAnn Pushkin about density notification and supplemental screening. Their position is that “Not notifying women about their dense breasts robs them of the opportunity to seek supplemental breast cancer screening and the chance to catch a cancer as early as possible.” The interview is available in podcast and article format:

Canadian Breast Screening Guidelines:

Updated Patient Q+A & More

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One of the most commonly asked questions from patients is, “If I have dense breasts and cancer might be missed on my mammogram, what else can I do?”  As part of our regular review to keep data as current as possible, that Q+A has just been updated and edited to be more patient friendly. (European visitors, please see Patient Q+A #18 here.)

Educational Opportunity:
A joint IAEA and SNMMI webinar, Molecular Breast Imaging: State of the Art, will provide nuclear medicine physicians/technologists, oncologists and breast surgeons with the most current information on the use of molecular breast imaging and dedicated breast PET imaging. When: Sept. 15th, 2022. Time: 11am-12:30pm (USA/Eastern). Credits: 1.5 CE

Updated Fact Sheet

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Our very popular Patient Fact Sheet has just been updated! The printable PDF provides basic dense breast info and encourages a conversation between a woman and her health team about supplemental screening. Feedback received is that it is a useful clinical flyer or health fair hand out. The Fact Sheet is available in 20+ languages.

As a reminder a full suite of patient content, including printable tools, is available at:

  1. DB-i “For Patients” tab
  2. DB-i/Europe, ”European Patients” tab
  3. DB-i/Spanish tab

Canadian Screening Outcomes Call into Question Current Canadian Task Force Guidelines

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 A study co-authored by DB-i Medical Advisory Board member Dr. Seely just out: The Impact of Organised Screening Programs on Breast Cancer Stage at Diagnosis for Canadian Women Aged 40-40 and 50-59.  In 2011, the guidelines changed from those in 2001 which stated, “Upon reaching the age of 40 Canadian women should be informed of the potential benefits and risks of screening mammography and assisted in deciding at what age they wish to initiate the manoeuvre” to 2011 Canadian Task Force guidelines, ”For women aged 40–49 years, we recommend not routinely screening with mammography.”  As a result, only 4 provincial screening programs in Canada currently allow women to self-refer for mammography starting at age 40.

The study evaluated changes in the incidence of breast cancer by stage from 2011 to 2017. Due to reduced mammographic screening for women in their 40s, over the 6 years of the study, the authors found:

  1. Women in their 40s had a 13.6% decrease in incidence of stage I and a significant 12.6% increase in stage II disease.
  2. For women in their 50s, the incidence of stage II disease increased by 3.1%
  3. In provinces that did not continue to have organised screening programs for women 40-49, there was a 10.3% increase in stage IV breast cancer in women 50-59 over the six years.

The findings support the recently updated National Comprehensive Cancer Network guidelines that recommend annual screening mammography for average-risk women beginning at age 40.

National Comprehensive Cancer Network (NCCN) News & More

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Patient health literacy is in the air! Following the news of DB-i’s health literacy review of website patient content, the NCCN has published new patient guidelines in patient-friendly plain language. The new guidelines were developed to help patients ask the right questions about when and how often to screen for breast cancer. The guidelines emphasize annual mammograms for all average-risk women over 40. Please visit the NCCN’s 2022 Breast Cancer Screening and Diagnosis guidelines to learn more.

Recently Published
A research article co-authored by DB-i Medical Advisory Board member Dr. Jean Seely was published in BMC Cancer, Randomized trial of surveillance with abbreviated MRI in women with a personal history of breast cancer– impact on patient anxiety and cancer detection. The study aimed to determine if surveillance mammography plus abbreviated MRI reduced psychological distress and if abbreviated MRI improved cancer detection rates as compared to mammography alone.

Health Care Provider and Patient Outreach

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Reaching Health Care Providers:

To address the educational needs of both the radiological and referring provider communities, DB-i will begin running ads through the end of 2022 in the Society or Breast Imaging and American College of Osteopathic Obstetricians and Gynecologists newsletters. Our goal is to highlight DB-i educational tools, in particular the CME/CE course, Dense Breasts and Supplemental Screening.

This complements DB-i’s existing effort to reach the ob/gyn community through our interactive quiz featured in OBG Management magazine, “In the Know with Dense Breast Info” (quizzes below):

  1. Quiz #1, How is a woman determined to have dense breast tissue?
  2. Quiz #2, True or false: Breast density increases breast cancer risk
  3. Quiz #3,In which categories of breast density does tomosynthesis/3D mammography increase cancer detection over standard digital mammography?
  4. Quiz #4,Average-risk women with dense breasts—What breast screening is appropriate?
  5. Quiz #5, Your 28-year-old patient has a first-degree relative with a known disease-causing BRCA1 or BRCA2 mutation, but she herself has not been tested. Which breast screening method(s) should you recommend?
  6. Quiz #6, What are the reasons to use the Gail risk assessment model?

Reaching Patients:

DB-i has been very successful in reaching, educating, and engaging women through social media. The attached image is a popular example.

Patient Advisory Group (PAG) Launched

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As it is important that patients have a voice at the table about the DB-i website, we have launched a PAG. Our PAG members provide their unique perspective on website content needs, understandability, and user experience. Notably, each PAG member contacted us after visiting the website as they were impressed with the depth and breadth of content. The PAG has been instrumental in content review as part of our health literacy project. Please see our Press Release about this DB-i initiative.

This ongoing effort will ensure that health professionals can feel confident about the relevancy and useability of the DB-i website as an educational resource for patients. 

New U.S. Federal Law
The Making Advances in Mammography and Medical Options for Veterans Act (Public Law 117-135) tasks the Secretary of Veterans Affairs with developing a strategic plan for improving breast imaging services for veterans including the evolving needs of women veterans, geographic disparities of breast imaging, and the use of 3D tomosynthesis.

Health Care FAQ Update

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We have received queries from health professionals in the U.S. about how to write an order for supplemental screening. With the input of our Medical Advisory Board, we have reviewed and updated FAQ #26 “If my dense-breasted patient would like supplemental screening after her mammogram, how should I write the order?”

The full list of 50+ Health Provider FAQs can be accessed here (and for our EU colleagues, here).

As a reminder, comprehensive lists of Patient Q+As are available in website sections:

  1. DB-i/Home
  2. DB-i/Europe
  3. DB-i/Spanish

New U.S. State Law & More

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The state of Ohio has a new law which requires (1) updated and more comprehensive density “inform” notification to patients and, (2) new expanded insurance coverage for breast imaging (both effective 9/23/2022). Please visit our MAP or TABLE for more information.

Newly Published
Original research just published in the Journal of Breast Imaging, Breast Density Legislation Impact on Breast Cancer Screening and Risk Assessment. The findings show that breast imaging facilities in states with breast density inform laws often offer supplemental screening compared to facilities in states without “inform” laws. Further, a statistically significant proportion of facilities in non-inform states had no supplemental screening nor plans for implementation.

Upcoming Meetings

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European Congress of Radiology
DenseBreast-info.org/Europe will be attending the European Congress of Radiology (#ECR2022), July 13 – 17 in Vienna. Both DB-i’s European Liaison, Dr. Athina Vourtsis, and Education Coordinator, Cheryl Cruwys, will be there. If you are attending, the DB-i/Europe team would be delighted to see you! The #ECR2022 theme is “Patients in Focus” with an extensive programme.

Look for the DenseBreast-info.org/Europe exhibition stand and promotional banner located in the Annex (left of Tech Gate Auditorium, at the back of the Tech Gate lobby area).

Mark your calendars!
The 7th biennial Why Study Mammographic Density? conference will take place in-person (Melbourne, Australia) and online on September 27-28, 2022. The two-day hybrid event aims to share new research and knowledge concerning mammographic density and brings together a multi-disciplinary mix of researchers, clinicians, consumers, industry providers and policy makers.

New Insurance Laws and Other Updates

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U.S. State Insurance Laws:
An expanded insurance law has been signed in Oklahoma. The Tennessee law has just been assigned an “effective date:”

  1. Oklahoma’s new law (effective 11/1/22) expands coverage for mammography and diagnostic imaging
  2. Tennessee’s law (previously reported) has been assigned an “effective date” of 5/25/22 (already in effect)
  3. Learn more about these and other state “inform” and insurance laws in DB-i’s legislation MAP or TABLE.

NEW! A MAP of Expanded Insurance Laws by State has been created. A reminder that state insurance laws vary in coverage and the full MAP or TABLE should be checked for specific state details.


New Education Supporters!
We are pleased to welcome Delphinus Medical Technologies  and Fujifilm Healthcare Americas as new Corporate Supporters. We are grateful for the generous funding and enthusiastic co-educators who champion the comprehensive resources on the DB-i website.

Breast Screening Flow Charts

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  • In the absence of U.S.A. national screening guidelines for women with dense breasts, the DB-i Medical Advisory Board has developed screening flow chart, Who Needs More Screening? The proposed strategy, which includes risk assessment and possible genetic testing by age 30, is designed to identify the high risk woman and optimize cancer detection.
  • Just updated: The European Screening Decision Support Tool now includes EUSOBI 2022 MRI screening guidelines for women aged 50-70 with extremely dense breasts.

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