NEW! Screening Technology Info for Patients
The FDA requirement for density inform is around the corner, and with it will come new patient/provider conversations about what it means and what to do. To gear up, DBI has developed simplified, introductory content for patients, Screening Tests After a Mammogram. We extend thanks to our hardworking Patient Advisory Group who devoted much time and input into its development. Please visit and share the new page!
Blog
Breast Cancer Screening Updates from Canada
While Canadian breast cancer screening advocates celebrated the Canadian Cancer Society’s endorsement of lowering the screening age to 40, unfortunately the soon-to-be-released Canadian Task Force guidelines are unlikely to do the same. Ten out of twelve provinces with screening programs have lowered the screening age to 40, but it is still important that the Task Force do so as well, since Task Force guidelines would inform primary care providers who often discourage breast screening until the age of 50. Despite the increasing incidence of women in their 40s presenting with advanced breast cancers, the Task Force does not seem poised to lower the recommended screening age.
TOCEM Interim Analysis
Just Published in Radiology
Addition of Contrast-enhanced Mammography to Tomosynthesis for Breast Cancer Detection in Women with a Personal History of Breast Cancer: Prospective TOCEM Trial Interim Analysis. Women with a personal history of breast cancer are at higher risk for second cancers and for having that cancer missed on mammography. Interim analysis from the ongoing TOCEM study, led by DBI Chief Scientific Advisor Dr. Berg, shows very favorable results using annual screening contrast-enhanced mammography (CEM) after tomosynthesis, with added cancer yield of 7/1000 in year 1 and 4/1000 in years 2 and 3, small median invasive tumor size of 0.6 cm, mostly node negative. Added recalls occurred in 6.6% women year 1 and 5% in subsequent years.
USPSTF Recommendations, State Insurance Laws
USPSTF Guidelines / Editorial by Dr. Wendie Berg
The United States Preventative Services Task Force (USPSTF) has released a Task Force Recommendation Statement for breast screening. DBI’s Chief Scientific Advisor, Dr Wendie Berg, was invited to respond in an editorial on the key advances and opportunities to enhance breast screening guidelines moving forward: USPSTF Breast Cancer Screening Guidelines Do Not Go Far Enough. [See DBI announcement for a summary of details.]
U.S. State Insurance Laws
Two new states, Iowa and Vermont, have enacted insurance laws for expanded breast imaging coverage after a mammogram.
EUSOBI Updated Guidelines, Insurance Laws, NYT Article
EUSOBI Updated Breast Cancer Screening Recommendations
Please see this article in Diagnostic Imaging for a summary of the new EUSOBI recommendations. While 2022 recommendations focused specifically on women with extremely dense breasts, updated recommendations aimed to give a general overview of current recommendations for screening all women – including risk assessment at a young age, general population screening, and high-risk screening for women with BRCA mutations.
New York Times
A recent article, Some Older Women Need Extra Breast Scans. Why Won’t Medicare Pay?, published in the New York Times garnered so much interest and so many comments that a follow up article has been scheduled. DBI has provided quotes and material for both.
DBI on Capitol Hill, Density Request Forms
The World’s Leading Resource on Dense Breasts, Now Leads the Fight for the Find It Early Act
DBI had a full schedule on Capitol Hill last week meeting with key Congressional members. The federal bill would ensure all health insurance plans cover screening and diagnostic imaging with no out-of-pocket costs for women with dense breasts or higher risk for breast cancer. WE NEED YOU TO TAKE ACTION. Please share your perspective/examples of denials for coverage for supplemental imaging, resulting delayed screening, unexpected insurance costs, etc., with your congressperson. FYI, congressional members have made it clear that personal direct reach outs are much more effective than petitions. Please contact your congressperson and ask for them to support the bill, learn how HERE.
Patient Density Request Forms
Women out of the U.S. have asked for a resource to request their breast density after their mammograms. DBI features 5 versions of a Patient Density Request Form for specific health systems, the newest version in Arabic.
Density Request forms are available as free downloads:
Kentucky Insurance Law, AI for Supplemental Screening
New U.S. State Insurance Law
The state of Kentucky becomes the 28th state to enact a law requiring some level of insurance coverage for additional breast imaging after a mammogram.
New Study
Just out in Radiology, study Use of an AI Score Combining Cancer Signs, Masking, and Risk to Select Patients for Supplemental Breast Cancer Screening. This large retrospective study found that an AI-based risk model incorporating cancer signs, masking and risk was superior to breast density alone in identifying patients with a negative screening mammogram who were likely to develop subsequent breast cancer. The AI-based risk model, known as AISmartDensity, identified 33% of future cancers compared to 13% for the density-based model.
SBI Meeting, Please Visit Booth #505
Please stop by at SBI!
On September 10, 2024, dense breast reporting to patients and their providers will become a U.S. federal requirement. In Canada, 12 out of 12 jurisdictions will soon be telling women their breast density. These developments will lead to new patient/provider conversations about the screening and risk implications of dense tissue and supplemental screening. Providers should be prepared to either be a resource or recommend one on the topic. Are you ready?
DenseBreast-info.org is the world’s leading medically sourced website on the topic and provides free educational tools for both patients and providers. Please visit us in booth #505 to learn more.
Canada Inform, ILC Imaging, Research Grant
Density Inform / Canada
Good news from DenseBreastsCanada! Dense breast notification from coast to coast goes into effect this summer in Canada! Well done to advocates Jennie Dale and MAB member Dr. Paula Gordon for their tireless efforts.
JBI Article on Imaging for ILC
In an article co-authored by MAB members Drs. Wendie Berg and Lars Grimm, the majority of SBI member radiologists surveyed felt that additional screening beyond mammography was needed to detect ILC in dense breasts, to image extent, and in women of all breast densities with treated ILC.
New Research Grant
Congratulations to Dr. Wendie Berg on the award of a research grant from the PA Breast Cancer Coalition as co-PI with Dr. Shandong Wu to study the use of AI added to contrast-enhanced mammography to reduce false positives in screening!
Risk Model Tutorial
There has been a lot of celebrity news this week around risk assessment and models. We’d like to remind you that DBI features a Risk Model Tutorial; click the link for details on how the models are used, risk model explanations, diagnostic considerations, and for a Risk Models Table with live links to the models.
Updated FAQs
Does estrogen or HRT affect breast density or breast cancer risk? This is a common question and we have conducted a literature review. Please see DBI’s updated Patient and Health Providers FAQs on the topics:
For Patients
- Does taking estrogen increase breast density or breast cancer risk?
- Does taking hormone replacement therapy (HRT) treatment increase breast density or breast cancer risk?
For Providers
New State Inform Law, ESR Gold Medal Recipient
U.S. State Inform Law
Better late than never! Indiana has enacted a breast density inform law (effective July 1, 2024) which mirrors the new FDA required “dense breast” reporting language (effective Sept 10, 2024). This brings the number of states with inform laws to 39 and the District of Columbia. Please see DBI’s legislation MAP or TABLE for more details.
European Congress of Radiology – Highlight
Congratulations to Prof. Boris Brkljačić, Chair of the EuroSafe Imaging Steering Committee and DenseBreast-info.org/Europe Education Supporter! Prof. Brkljačić was awarded the ESR Gold Medal, the highest honour bestowed by the society, at the ECR 2024 Opening Ceremony.
New Insurance Bill, State vs FDA “Inform” Requirements
U.S. State Insurance Bill Update
Massachusetts has become the latest state to introduce an insurance bill for expanded breast imaging beyond a mammogram.
State “Inform” Laws and the FDA Reporting Standard
We have received questions about existing state dense breast inform laws and the imminent FDA dense breast reporting standard. It is important to note that existing state density inform laws may remain in effect in addition to the FDA requirement unless that state law specifically defaults to the new FDA standard, expires, or is repealed. FDA guidance is that mammography facilities should be aware of and comply with all applicable local, state, and federal “dense breast” reporting requirements. More information, including how to contact the FDA with questions, is available here.
ECR Meeting, New MAB Member
European Congress of Radiology
DenseBreast-info.org/Europe will be attending #ECR2024, (Feb 28 – March 3) in Vienna. Both DBI’s European Liaison Dr. Athina Vourtsis, and Education Coordinator Cheryl Cruwys, will be on hand. Please visit the DBI/Europe team in the Austria Center, Level 1, Foyer 1, at the ESR Patient Advisory Group booth.
Medical Advisory Board
Please join us in welcoming Dr. Ellen Mendelson to DBI’s stellar Medical Advisory Board! Dr. Mendelson is Professor Emeritus of Radiology and formerly Division Chief of Breast and Women’s Imaging at Northwestern University Feinberg School of Medicine in Chicago, IL. Her extensive clinical research includes authorship and co-authorship of over 34 peer reviewed articles and participation in 2 clinical trials in the past 15 years. Dr. Mendelson’s long-awaited textbook on automated breast ultrasound is scheduled for publication in late 2024, (Mendelson, Vourtsis, and Spear, eds. Automated Breast Ultrasound for Screening and Diagnosis, Elsevier).
Updated Technology Tab Info, New Co-Educator
Screening Technologies Update
DBI’s Screening Technologies tab has just been updated! For easy reference, each updated modality section now includes “Quick Facts” bullets in the introduction. Many thanks to our hard-working Medical Advisory Board for their editorial input.
Coming soon: The new FDA dense breast reporting standard goes into effect in September and will result in new patient/provider conversations about supplemental screening. To help inform patients about supplemental screening options, DBI will be launching a dedicated patient-friendly screening technology section. Stay tuned!
New Education Co-Educator
Service Women’s Action Network (SWAN) is “the voice of all military women” including the 350,000 active service women and 2 million women veterans in the U.S. We welcome SWAN to our Education Coalition and are honored the organization now includes DBI as a resource for members: https://www.servicewomensactionnetwork.org/obgyn
New Insurance Bills, The Patient’s Perspective
U.S. Insurance bills
New insurance bills for coverage of expanded breast imaging have been introduced in the states of Iowa and Oklahoma.
SBI Newsletter
SBI’s Winter 2024 newsletter includes an interview with DBI’s JoAnn Pushkin, in The Patient’s Perspective column, about the patient dense breast experience, advocacy efforts and next steps on the legislative front.