DenseBreast-info.org/Europe will be exhibiting at #ECR2023 from March 2-5. DBI’s European Liaison Dr. Athina Vourtsis, and Education Coordinator Cheryl Cruwys, will be on hand.
Europe
A British Institute of Radiology (BIR) blog just out on breast density authored by DBI European Education Coordinator Cheryl Cruwys. The piece, ‘Why Understanding Breast Density Matters’, also provides an overview of the DBI/Europe website resources.
Just Published
Out in Radiology Beyond Breast Density: Risk Measures for Breast Cancer in Multiple Imaging Modalities, co-authored by MAB member Dr Emily Conant. Beyond breast density, the article describes the range of imaging markers associated with breast cancer risk in digital mammography, digital breast tomosynthesis, whole-breast US, and MRI.
Want to get involved? Check the Find It Early Act webpage for information on how to contact a congressperson, how to schedule a meeting, what to bring, what to ask, and follow up suggestions. This “Lobbying 101” page was developed with feedback from Rep. Rosa DeLauro’s office on best practices and input from our Patient Advisory Group on language.
Newly Published
Out in Radiology, Supplemental Breast Cancer Screening in Women with Dense Breasts and Negative Mammography: A Systematic Review and Meta-Analysis with accompanying editorial by MAB member Dr Regina Hooley. In a meta-analysis of 3D mammography, ultrasound, or MRI to supplement 2D mammography, Hussein et al report results consistent with the literature that screening MRI outperforms anatomic imaging in cancer detection. MRI found 26 cancers per 1000 women screened, with acceptable PPV of biopsy. Not all women can tolerate MRI, however, and, in their analysis, supplemental screening with either handheld or automated US found 4 cancers per 1000 women screened that were missed on mammography.
U.S. State Density Inform Bill and Insurance Bills
West Virginia has introduced two density “inform” bills; please see DBI’s updated legislation MAP for details. And, insurance bill introductions requiring coverage for expanded breast imaging continue with 20+ bills so far!
Europe: Screening Guidelines
Greece now has a national (organized) screening program. Please find updated information by country in our European Screening Guidelines MAP and TABLE.
Patient Equity: Density Inform and Insurance
Will 2023 be the year that both a national reporting standard and a federal insurance mandate for no-cost additional imaging become a reality in the U.S.? Just published in ITNonline, “Creating Patient Equity: A Breast Density Legislative Update.”
New Research
Just out in JAMA Network, Perceptions of Breast Cancer Risks Among Women Receiving Mammograph Screening, which suggests that understanding of breast density’s contribution to breast cancer risk remains underappreciated by many women.
Canada
The Canadian Society of Breast Imaging has just issued a new Position Statement on Breast Arterial Calcification Reporting on Mammography.
As mentioned, a U.S. federal bill for expanded breast imaging coverage, the Find It Early Act, has been introduced. While that legislation progresses on the federal level, 10 individual states have also introduced 2023 bills for expanded breast imaging insurance coverage. This is the beginning of most state legislative sessions, and more bills may be introduced.
The individual bills vary in scope of proposed coverage; please click on the link for actual bill content. Please note, a bill is often amended as it moves through the legislative process and bill language may not reflect the final language if signed into law.
Delaware HB60
Hawaii SB273
Missouri HB575
HB147
Mississippi SB2219
Nebraska LB145
New Mexico HB27
New Jersey A4550
Pennsylvania* SB1225
Virginia SB1368
Washington SB5396
*Pennsylvania’s bill carried over from the 2022 session
Topic: Tech Performed Handheld Ultrasound After 3D
Just published in the Journal of Clinical Oncology, authored by Dr. Wendie Berg, and coauthored by Dr. Marcela Böhm-Vélez and others, Prospective Multicenter Diagnostic Performance of Technologist-Performed Screening Breast Ultrasound after Tomosynthesis in Women with Dense Breasts (the DBTUST).
Topic: Knowledge Gaps About Breast Cancer Risk Model Use/High-risk Screening
DBI’s third research project just out in the Journal of Breast Imaging, Effect of an Educational Intervention on Women’s Health Care Provider Knowledge Gaps About Breast Cancer Risk Model Use and High-risk Screening Recommendations.
The Find It Early Act, a federal bill for or expanded insurance coverage for no-cost screening and diagnostic imaging for women with dense breasts or at increased risk, can be accessed HERE. Please save and check this page for bill updates.
MAB Member Honored
Congratulations are in order! Dr. Paula Gordon has been appointed to the Order of Canada which honors citizens who make extraordinary contributions to the nation. Dr. Gordon was specifically recognized for “advancing ultrasound imaging and technology in the early detection of breast cancer, as a prominent radiologist and researcher.”
Federal legislation that would require insurers to cover no cost-sharing additional breast imaging for women with dense breasts or at higher risk for breast cancer, the “Find It Early Act”, was announced on Capitol Hill. This legislation should help address insurance barriers which contribute to the lack of health equity.
DBI’s JoAnn Pushkin joined Reps. Rosa DeLauro and Brian Fitzpatrick and journalist Katie Couric to speak at the press conference. Creative credit goes to Dr. Wendie Berg for her suggestion that the DBI tagline “Find it Early” be considered as the bill’s name.
While a bill number/link is pending, below is an excerpt from the bill:
COVERAGE WITH NO COST-SHARING FOR ADDITIONAL BREAST SCREENINGS FOR CERTAIN INDIVIDUALS AT GREATER RISK FOR BREAST CANCER
Patient Fact Sheets
The DBI website features a full suite of patient education content including FAQs, videos and printable materials. Our very popular one-page downloadable Patient Fact Sheets are now available in over 25 languages, the most recent in Czech.
RSNA Follow Up /Medical Advisory Board
Amazon Smile Program
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The most often heard comment from RSNA attendees in Chicago this week was that though attendance was not quite what it was pre-Covid, the energy and crowds were “back.” Some density-related highlights:
RSNA
The 108th meeting of the Radiological Society of North America will take place November 27 – December 1. Educational opportunities from our Medical Advisory Board (MAB) members include:
New Study in Current Oncology
A prospective study, co-authored by MAB member Dr. Jean Seely, Feasibility Study and Clinical Impact of Incorporating Breast Tissue Density in High-Risk Breast Cancer Screening Assessment, assessed the feasibility and impact of incorporating breast tissue density (BTD) into the risk assessment of women referred to the High-Risk Ontario Breast Screening Program who were not genetic mutation carriers. Results showed that Incorporating BTD into risk assessment was feasible, did not increase the overall number of women eligible for B-MRI, and optimized supplemental B-MRI screening in women with dense breasts.
Educating Providers in Related Disciplines
A concise presentation by Dr. Wendie Berg, Breast Density Notification Rule: 2022 FDA, just aired on Oncology Tube. Topics included the implications of dense tissue, details on supplemental screening options, and the upcoming FDA national reporting standard.
National Rad Tech Week
This week was National Rad Tech Week in the U.S. DBI highlighted the day by sharing a fan-favorite YouTube video of mammographer Cindy Staker discussing the importance of positioning and the role technologists play in cancer detection. if you haven’t seen this powerful short video, it’s worth the watch/share, here.
Federal Insurance Legislation
Congresswoman Rosa DeLauro (Connecticut) will soon introduce federal legislation that requires insurers to cover no-cost additional breast imaging for women with dense breasts or at higher risk for breast cancer. Given DBI’s experience in bill analysis, Executive Director JoAnn Pushkin and Chief Scientific Advisor Dr. Wendie Berg were asked to review and offer input on bill language. We are particularly delighted that the DBI tagline “Find it Early” is being used as the bill’s name! More news on the introduction of the Find it Early Act will follow.
Federal Standardized Dense Breast Notification
The proposed insurance legislation complements the national “dense breast” reporting standard, also under development. As a reminder, the FDA is advancing a standard for breast density notification for American women and anticipates that this will happen by early 2023. Until that time, details on individual state inform laws are available here.
Updated Table:
As new research is published, website content is reviewed to incorporate it. Newly updated is the popular Technology Tab table, Cancer Detection by Screening Method.
DBI in the News:
Breast Cancer Awareness Month and news of an updated FDA timeline for a U.S. national “dense breast” reporting standard resulted in much demand for DBI comments, story input, and images. Below are some national media opportunities we were included in:
U.S. National “Dense Breast” Reporting Standard
U.S. Congresswoman Rosa DeLauro has announced that the FDA is advancing a standard for breast density notification for American women. The FDA anticipates that this will happen by early 2023. Read Rep. DeLauro’s press release HERE.
Patient Fact Sheets
Our popular Patient Fact Sheets are now available in 25 languages. Newly added are Chinese versions in Cantonese, Mandarin (Simplified), and Mandarin (Traditional). Our thanks go to Dr. Steven Cai and Ms. Nicky Li for translation assistance!
