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DB-i Audience Growth Update

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Have you noticed the new pop-up when you log on to the DB-i site? It’s a short form inviting visitors to sign-up for ongoing updates from DB-i. And they are! We are averaging 40+ new contacts/week, with nearly 500 added to our database already. While only our Educational Supporters and Medical Advisory Board receive these insider Fast Fact Friday emails, our general list of nearly 6,000 contacts receives monthly email updates highlighting breast density news/implications and available educational tools on the site.

We are on track for 200,000 website visitors this year – wonder where everyone heads once they log on?  The top three pages accessed are:

1.       Mammography/3D Mammography/Tomosynthesis

2.       Risk Model Calculators

3.       Breast Ultrasound

Thank you for your continued engagement and support!

DB-i Representatives in Industry Publications and Events

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JBI Article – Screening Breast Ultrasound Using Handheld or Automatic Technique in Women with Dense Breasts

In the current issue of the Journal of Breast Imaging, Drs. Wendie Berg and Athina Vourtsis review technique and outcomes from literature on over 400,000 screening ultrasound exams in women with dense breasts. Both handheld and automated techniques consistently reveal another 2-3 cancers per 1000 women screened, not seen on mammography, with an average of 7-10% of women requiring additional testing because of abnormalities on screening ultrasound. Nearly 90% of cancers found on screening ultrasound are invasive and node negative, i.e. those with the most favorable prognosis. The entire article can be downloaded for free.

DB-i Welcomes Education Ambassador for Portugal
DB-i extends a warm welcome to Dr. Mónica Armas, who recently joined DB-i as the Education Ambassador for Portugal. Dr. Armas is Attending Radiologist, Department of Radiology, SESARAM, EPE, Funchal and holds a Master in Breast Pathology from the University of Barcelona. Our thanks to Dr. Armas for provided the input needed to include Portugal in the European Screening Guidelines map. We look forward to working with Dr. Armas in the future.

RSNA 2019
We know many of you will soon be heading out to Chicago for RSNA. If you want an update on density legislation, catch JoAnn Pushkin’s talk  “Density ‘Inform’ and Insurance Legislation Update.” Monday 12/1, 8:30am, Room S105D.

Success: Free CME Month!

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The numbers are in! The free CME month promoted by our Educational Supporters in September was enormously successful. Enrollment for the course showed a ten-fold increase over the previous two months. Many thanks to our Supporters who were exclusive promoters of the promotion. Enrollees overwhelmingly rated the course as “Excellent” and provided valuable feedback about why it was useful to them.Below are just a few of the direct quotes from enrollees:

  • “This gave me the information that I would need to have an educated conversation with patients and providers alike.”
  • “I much better understand the implications of density noted on the reports I’m getting. I also now understand the difference between imaging techniques and when to use them.”
  • “I will recommend additional screening more often in women with dense tissue.”
  • “Many women presenting for screening ask about density now. This course has explained how important a risk factor density can be.”
  • “I am now better equipped to suggest adjuvant modalities based on density and other risk factors.”
  • “I will pay more attention to breast density reports on mammograms and advise additional screening when indicated.”

Our thanks to all of you for your efforts to promote this educational opportunity to your contacts. We look forward to Free CME 2020!

#DenseBreastDay 2019, AJR Publication, and More European News

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#DenseBreastDay 2019The reports are in for #DenseBreastDay performance and we logged well over 30,000 reach/impressions. We are very pleased with the results; see some of the details below! DB-i FacebookTotal day reach: 13,123 Top post: “Your Breasts. Your Health.”

DB-i Twitter:
Total day impressions: 17,415 Top tweet: “A new law will soon require notification…”

There was good press around the event, as well. In addition to major industry media, the DB-i press release was also picked up by 137 non-industry media outlets. Our thanks to all of you who posted, re-tweeted and liked our #DBD posts, including Joan Lunden, who re-tweeted three of our tweets. We look forward to #DenseBreastDay 2020!

American Journal of Roentgenology (AJR) Publication: Dense Breast Ultrasound Screening After Digital Mammography Versus After Digital Breast Tomosynthesis
Researchers at Brown University reviewed results of technologist-performed handheld ultrasound in supplemental screening of women with dense breasts after implementation of Rhode Island’s density inform legislation went into effect in October 2014. They found that additional ultrasound cancer detection after tomosynthesis was 3.0/1000 women screened, which was similar to the number of additional cancers detected after 2D mammography at 3.5/1000 women screened (p=0.999). Median size of invasive cancers seen only on US was 1.0 cm.

ESR President and DB-i Education Ambassador for Croatia:
Our congratulations to Professor Boris Brkljačić, ESR President and DB-i Education Ambassador for Croatia, for obtaining Honorary Membership of the Irish Faculty of Radiologists during their Annual Scientific Meeting!

European Outreach Expands

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Education Ambassador and European Screening Guidelines Map:
We continue to expand our European education coalition and are delighted to welcome on board Dr. Magnús A. Lúðvíksson as an Ambassador representing Iceland. Dr. Lúðvíksson is a general and breast radiologist at the Landspitali University Hospital in Reykjavik and a member of the Radiological Societies of Iceland, the Netherlands and the RSNA. He is also the society delegate of the Radiological Society of Iceland in the Education Committee of the ESR and represents their Radiological Society in the UEMS Section Radiology and is a member at large of the Communication and External Affairs Committee of the ESR. Please see the updated European Map which now includes information from Iceland. Please join us in welcoming Dr. Lúðvíksson to the team!

ecancer medical science:
Cheryl Cruwys, DB-i’s European Educational Coordinator, attended the ecancer medical science editorial board meeting on September 25th. ecancer is an international oncology educational resource and has been a valued voice in promoting breast density education. Cheryl joined the Editorial Board in May 2019.

Upcoming Events: EUSOBI Annual Scientific Conference and More

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#DenseBreastDay 2019:
The second annual #DenseBreastDay is two days away! This day-long social media blitz, hosted in conjunction with Yale Medicine, will take place Wednesday, September 25th, beginning at 8:30am. The whole day will be dedicated to spreading awareness and understanding of the impact of breast density and breast cancer risk. Additional details can be found in the press release issued on Friday. Please mark your calendars for September 25, follow us on Twitter and Facebook, and feel free to join the conversation!

Free CME-CE Month:
Only ten days left for health care professionals to take advantage of free tuition for the CME-CE course Breast Density: Why it Matters. Please remind your contacts about this opportunity to gain a detailed understanding about breast density, prepare themselves for conversations with their patients about risks and screening options, and earn credits while doing so, all at no cost!

DB-i Participation at EUSOBI:
Dr. Athina Vourtsis, DB-i’s European Liaison, will lecture on Personalized Screening and Risk Stratification at the EUSOBI Annual Scientific Conference, which will be held October 3 – 5, 2019 in Budapest, Hungary. In addition, Cheryl Cruwys, European Education Coordinator, will be manning Stand 14 and will be available to answer questions and provide literature. If you are attending, please take time to attend Dr. Vourtsis’ lecture and visit the stand to meet Cheryl.

Risk Model Explanation and Expanding Outreach

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Risk Model Explanation Section:
Did you know that DenseBreast-info.org features a risk model tutorial section? Learn more about how the models are used, explanations about different risk models, diagnostic considerations, and see a quick-reference Risk Model table (with live links to models). The recently updated Risk Model Explanations section also includes details about the two risk models that do include breast density in their algorithms. Please share this valuable resource!

Fun Fact on International Outreach:
The Republic of China Radiation Medicine Association (RSROC.org.tw) is linking to DB-i from an article on their website’s “education” area. We are delighted with this recognition!

Illinois Insurance Laws Update

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An Illinois insurance amendment, effective January 1, 2020, adds coverage of medically-necessary diagnostic mammograms to already existing required coverage of screening tests – all with no copay/deductible* to the patient. Illinois is one of 9 states (and the District of Columbia) mandating some level of insurance coverage for breast cancer screening beyond mammography and/or diagnostic imaging. See full details on the DB-i legislative map and table.

*A state insurance law does not necessarily apply to all policies within a state. Further, national insurance providers may be exempt from state laws.

Second Annual Dense Breast Day, Plus Free CME Course in September

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CME Promotion:
We thank our friends at the SBI for featuring our CME/CE course Breast Density: Why it Matters in their June 2019 newsletter (Volume 1, Issue 2). Heads up! The course will be FREE the entire month of September, and we anticipate a hefty upsurge of professionals enrolling during the promotion. Don’t forget to let your contacts and colleagues know about this opportunity!
Second Annual #DenseBreastDay:
In conjunction with Yale University, we will be kicking off Breast Cancer Awareness Month, by hosting the second annual #DenseBreastDay. #DBD is a one-day social media education blitz with posts scheduled every half hour on the screening and risk implications of dense tissue and educational tools. Stay tuned for details about how your organization can help support #DenseBreastDay.

Online Publication in Radiology

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Study findings [1] published online August 13, 2019 in Radiology concluded: “Digital breast tomosynthesis enabled the detection of more cancers in all density and age groups compared with digital mammography, especially cancers classified as spiculated masses and architectural distortions. The improvement in cancer detection rate showed a positive correlation with age. With use of digital breast tomosynthesis, false-positive findings were lower due to fewer asymmetric densities, except in extremely dense breasts.” The study abstract can be accessed here (subscription required for full text).

An accompanying editorial, Can Digital Breast Tomosynthesis Solve the Challenge of Dense Breast Parenchyma? was authored by Drs. Fuchsjäger and Adelsmayr, from the University of Graz, Austria. Dr. Fuchsjäger also serves as the DB-i/Europe Education Ambassador for Austria.

While this study provides further confirmation of the benefit of 3D mammography in screening dense breasts, DB-i’s FAQ #30 for health care professionals addresses the question of whether there is a benefit to screening ultrasound after 3D mammography (Hint – there is).

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1. Osteras, BH, Martinsen, AC, Gullien, R, et al. Digital Mammography versus Breast Tomosynthesis: Impact of Breast Density on Diagnostic Performance in Population-based Screening. Published online August 13, 2019; Radiology

New FAQ, New Insurance Law for New York and International Support

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New FAQ for Health Care Professionals:
Question #32, How do I identify women who are at higher risk who should have MRI? has been added to the Health Care Professionals FAQ list. This FAQ provides an overview of ACR recommendations for risk assessment and screening for women at higher risk for breast cancer.

Expanded Insurance Coverage in New York:
Effective 9/1/2019: For large group policies that provide coverage for hospital, surgical or medical care an annual mammogram for covered persons aged thirty-five through thirty-nine, inclusive, upon the recommendation of a physician, subject to the insurer’s determination that the mammogram is medically necessary. This coverage is not subject to annual deductibles or coinsurance. The DB-i Legislative Map has been updated to reflect this change. 

International Support:
The European Society of Radiology (ESR) tweeted and helped raise awareness of the DB-i CME opportunity for European providers and the publication authored by Drs. Berg and Vourtsis.

How Do State Inform Laws Compare?

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Question: How many state density inform laws require the mention of possible benefit of supplemental screening tests in dense breasts?

With 38 states and the District of Columbia having different and unique density inform laws, is there an easy way to do side-by-side comparisons and answer questions about what each law covers? Yes! The DB-i State Legislative Table provides a comprehensive, up-to-date break-down of 11 different parameters of each law.

Answer: Laws for 21 states and the District of Columbia require mention about the possible benefit of supplemental screening tests in dense breasts – note that none mandate supplemental tests.

Updates, Amendments and New Articles

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Technology Tab Updates:
Updates have now been completed for all modalities featured in the Screening Technologies section of the DB-i website. We are most grateful to our Medical Advisory Board for their dedicated time to ensure the DB-i website remains the most comprehensive, up-to-date resource available!Connecticut Insurance Legislation Amendments:
Effective 1/1/2020, Connecticut law sets a maximum of $20 for all out-of-pocket payments for ultrasound screening and requires insurance coverage for a baseline mammogram (2D or 3D) for women aged 35 to 39 years. Refer to the legislative map for full details.

Diagnostic Imaging Article:
The July 23, 2019 Diagnostic Imaging article, Stay Up to Date on Dense Breast Information, featuring JoAnn Pushkin, provides an excellent overview of density inform legislation and the educational resources available through DenseBreast-info.org.

Thank you for 1 Million Pageviews!

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Website Jackpot!
During the month of May 2019, DB-i surpassed the milestone of 1 million unique pageviews! With 1M+ views logged to date and the momentum fueled by social media and our Friends and Supporters, we are betting that the next million views will be achieved in half the time it took to get the first million. Any takers?

What are people viewing?
The five most frequently viewed pages for the first five months of 2019, in order of total # of views, are:

  • Mammography/3D Mammography/Tomosynthesis
  • Risk Model Calculators
  • Breast Ultrasound
  • Legislation
  • FAQs for Patients

Proposed MQSA Density Reporting Amendment:
As reported last week, DB-i has submitted comments to the FDA. In case you missed it, news of DB-i’s submission was highlighted in AuntMinnie and Radiology Business.

Comments on FDA Proposed Rule on Density Reporting

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The open period to provide comments on the FDA’s proposed amendments to the Mammography Quality and Safety Act (MQSA) ended June 26, 2019 and DB-i’s comment letter on the breast density reporting section of the amendment is posted on our website. We were encouraged to find that comments from a number of other national organizations expressed agreement (see below) with the DB-i recommendations and hope the final rule will reflect this support.

  • The American Cancer Society’s letter stated: “We are aware of recommendations that have been made by DenseBreast-info.org, and we think they are sensible.”
  • A group letter from 16 women’s health organizations, including Susan G. Komen, said: “We extend special thanks to DenseBreast-info.org for their leadership in the development of the recommended language.”
  • A number of state “inform” advocacy groups supported the DB-i language in their comments.

What’s Next?

All comments are currently being reviewed and a final rule will be published by the FDA when all submissions have been taken into consideration. The amendment will become effective 18 months following finalization, probably in early 2021. We will keep you posted of any developments.

FDA Proposed Rule on Density Inform, Are You Ready?

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DB-i Executive Director’s Article in Radiology Today:
Do you or any of your colleagues have questions about the history and status of the national breast density reporting standard? Will health care providers be “conversation ready” to help patients understand the screening and risk implications of dense breast tissue when the federal standard is in effect? An article in Radiology Today by DB-i Executive Director JoAnn Pushkin, Breast Density 2019 – Are You Ready?, is a useful guide to understanding and preparing for the implementation of national breast density inform regulations.

Please share this link with anyone who might find it useful. Many thanks to our Supporters who have already shared this article on social media.

Organizations Linking to DenseBreast-info.org
UCLA Breast Imaging and Breast360 (the American Society of Breast Surgeons Foundation) join the growing list of organizations providing a link to DenseBreast-info.

Are you interested in providing a link to us from your website? Visit our Link to Us page to fill out a request form.