The 10th International Breast Density & Cancer Risk Assessment Workshop will take place June 7-9, 2023, in Hawaii. Workshop topics to advance cancer research include: Clinical Aspects of Breast Density, Biology and Characteristics, Methods, Breast Cancer Risk Assessment and Next Generation Imaging Biomarkers.
Blog
New Insurance Laws and Other Updates
U.S. State Insurance Laws:
An expanded insurance law has been signed in Oklahoma. The Tennessee law has just been assigned an “effective date:”
- Oklahoma’s new law (effective 11/1/22) expands coverage for mammography and diagnostic imaging
- Tennessee’s law (previously reported) has been assigned an “effective date” of 5/25/22 (already in effect)
- 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
- 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.
Tennessee Insurance Legislation and More
Tennessee State Insurance Law:
Over a dozen U.S. states have active bills for varying levels of breast imaging insurance coverage. News! A Tennessee state bill has just been signed into law. Learn more about the Tennessee law and other state “inform” and insurance laws in DB-i’s legislation MAP or TABLE. (Please note, the effective date of the TN law is dependent on when it is assigned a “public chapter number”; we will provide that info when it is available.)
Newly Published:
MAB member Dr. Paula Gordon’s review article, The Impact of Dense Breasts on the Stage of Breast Cancer at Diagnosis: A Review and Options for Supplemental Screening is just out in Current Oncology. The article addresses the issue of dense breasts and the impact on the stage of breast cancer at the time of diagnosis and discusses options for supplemental screening.
SBI Wrap Up and Newly Published Research
SBI/ACR Breast Imaging Symposium Wrap Up:
The 2022 SBI/ACR Breast Imaging Symposium was packed with excellent presentations on a range of topics, including particular focus on artificial intelligence (AI) in breast imaging, which improves both early detection and risk assessment, and the importance of addressing disparities in breast imaging. Black women, American Indians, and Alaska natives are significantly more likely to be diagnosed with breast cancers at younger ages and later stages than non-Hispanic white women and are more likely to die from breast cancer. The importance of improving access to breast cancer screening and earlier risk assessment can’t be stressed enough.
Congratulations to DB-i’s Chief Scientific Advisor Dr. Wendie Berg and Medical Advisory Board members Drs. Stamatia Destounis, Carrie Hruska, Emily Conant, Jean Seely, Regina Hooley, and Laurie Margolies on their outstanding presentations and continuing to move the field forward.
Newly Published:
Just out in the Science Translational Medicine, research article, A risk model for digital breast tomosynthesis to predict breast cancer and guide clinical care. Modified from the abstract: Screening with digital breast tomosynthesis (DBT) improves breast cancer detection and reduces false positives. However, currently, no breast cancer risk model takes advantage of the additional information generated by DBT imaging for breast cancer risk prediction. A DBT-based short-term risk model was developed and internally validated for predicting future late-stage and interval breast cancers after negative screening exams. The model’s ability to distinguish women who were diagnosed with interval or late-stage cancers one year after a negative mammogram from those who were not (discrimination performance of 1-year risk), was considered excellent (AUC = 0.82), and higher than models using FFDM or traditional risk factors. In simulation modeling, if 12% of the women at highest risk had been offered supplemental screening, then potentially up to 59% of the cancers may have been detected compared with 39% of cancers using FFDM and 24% using lifestyle-family–based risk models.
U.S. State Insurance Laws
Currently 15 states have active legislation for expanded breast imaging insurance coverage (varying in scope). News! Insurance legislation in Connecticut and Georgia was signed into law this week:
- Connecticut law (effective 1/1/2023), extends breast imaging coverage for women ages 35 and under if they are believed to be at increased risk.
- Georgia law (effective 1/1/2023), covers diagnostic imaging, and supplemental breast imaging based on NCCN guidelines, with cost-sharing requirements “no less favorable than the cost-sharing requirements applicable to screening mammography.”
Learn more about individual State “inform” and insurance laws in our legislation MAP or TABLE.
National Women’s Health Week
#KnowBeforeYouGo
National Women’s Health Week kicks off on May 8th. To tie in and encourage mammography screening, DB-i will launch #KnowBeforeYouGo, a “mammogram and know-your-density reminder” social media campaign. Keep an eye on our Twitter and Facebook pages to participate by reposting and sharing these reminders.
About Our Education Coalition
DenseBreast-info is a non-profit public charity, and our mission is to provide guidance based on peer-reviewed clinical research. We do not accept advertising and all website content is manufacturer and modality “neutral.” We achieve our outreach with the assistance of unrestricted educational grants and donations, and DB-i is now the world’s leading website on the topic.
Our Education Coalition is Growing! We are pleased to welcome Myriad Genetics as a Corporate Supporter and Bayer AG as a European Supporter. We are grateful for the generous funding which assists in keeping this important tool viable and free.
In The Know with DenseBreast-info Quiz #6
Quiz #6 in the collaborative series with OBG Management magazine is now live. Each month’s quiz addresses a knowledge gap identified through the DB-i research study, Effect of an educational intervention on women’s healthcare provider knowledge gaps about breast density, breast cancer risk, and screening. Please share these with women’s health providers in your network.
- Quiz #1, How is a woman determined to have dense breast tissue?
- Quiz #2, True or false: Breast density increases breast cancer risk
- Quiz #3, In which categories of breast density does tomosynthesis/3D mammography increase cancer detection over standard digital mammography?
- Quiz #4, Average-risk women with dense breasts—What breast screening is appropriate?
- 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?
- Quiz #6, What are the reasons to use the Gail risk assessment model?
EUSOBI “Dense Breast” Recommendations / Editorial Comment
European Radiology just published an editorial comment, Breast MRI for the “Masses” authored by our Chief Scientific Advisor Dr. Wendie Berg. Dr. Berg notes that the EUSOBI guideline stops short of recommending additional screening for the approximately 40% of women with heterogeneously dense breasts. The editorial further states that shared decision making “…requires both women and providers to be informed and for pertinent options to be available.”
DenseBreast-info.org/Europe:
To support evolving “dense breast” conversations in Europe, a DB-I European expansion was launched in 2018 featuring EU specific content and advisors. Our dedicated DB-I/European Team works tirelessly to promote website resources and education on the topic. Dr. Athina Vourtsis is a both a Medical Advisory Board member and our European Liaison, and Cheryl Cruwys is our European Education Coordinator. You can meet both at ECR!
New Patient Tools & Upcoming CME Opportunity
Patient Questions and Answers:
NEW! Our Patient Question and Answer homepage has been redesigned to include a compelling animation of how a cancer might display on a mammogram in each of the 4 density categories. It now also provides quick access to the Top 5 questions/answers. This redesign is part of DB-I’s commitment to patient health literacy.
MAB Educators:
Join DB-I Drs. Wendie Berg and Athina Vourtsis for a free World Class CME webinar, Breast Density and the Need for Risk-stratified Screening Protocols, on April 20th, 3pm ET (1 AMA PRA Category 1 Credit ™ / 1 Category A CE credit).
DB-i Comment on EUSOBI Recommendations
After striving for years for the rights of women to be equitably engaged in breast cancer awareness, knowledge, and communication, we are delighted to welcome EUSOBI recommendations on patient density “inform” and supplemental screening MRI for women with extremely dense breasts. DenseBreast-info.org and DB-i/Europe provide important educational resources to health professionals and women on the implications of breast density and effectiveness of supplemental screening in women with dense breasts. In a comment authored by Drs. Vourtsis and Berg behalf of DenseBreast-info.org, “A change in paradigm of breast cancer screening in European women with extremely dense breasts” (3rd letter in the linked page), the letter also highlights the potential benefits and need for supplemental screening for women with heterogeneously dense breasts.
Errors in the Canadian Breast Screening Trials
Just out in the Journal of Breast Imaging: DB-I MAB members Drs. Jean Seely and Paula Gordon along with Drs. Peter Eby, Shushiela Appavoo and Martin Yaffe co-author “Errors in Conduct of the CNBSS Trials of Breast Cancer Screening Observed by Research Personnel.” The Canadian trials were used as evidence to discredit screening women in their 40’s.
The startling conclusion:
“These firsthand accounts provide new information confirming that the CNBSS did not consistently and rigorously assess the true efficacy of screening mammography. The staff accounts clarify reasons why the CNBSS results were outliers compared with the six other randomized trials of screening mammography and should not be used as credible scientific evidence to inform health policy.”
Health Literacy Review
Health literacy is the extent to which a person can receive, process, and understand health information to improve communication with their doctors and equip them to advocate for their own well-being. To evaluate DBI patient materials, we have embarked on content review in conjunction with a health literacy expert. This will be a multi-month project, but we wanted to share some early updates to DBI popular content:
- Dense Breasts: 5 Facts You Should Know
- New Question, “I have dense breasts and cancer might be missed on my mammogram. What else can I do?” .
National Physicians Week:
Today begins National Physicians week in the U.S. We recognize and thank DBI’s stellar team of medical advisors and educators! Look for social media posts this week.
Mammogram Reminders and MAB News
Erin Go Bragh!
In light of Covid-caused breast screening delays, DB-I has developed a series of “mammogram reminder” social media posts to encourage screening. Our playful St. Patrick’s Day post is attached.
Medical Advisory Board News
MAB member Dr. Regina Hooley’s recent Letter to the Editor, The Benefits of Early Breast Cancer Detection, was published in The New York Times (fourth letter in the linked page). She and co-author Dr. Susan Harvey weigh in on the “harms” of screening by highlighting the benefits of early detection and distinguishing between overdiagnosis and overtreatment.
New “Inform” Recommendations from EUSOBI!
Europe / Newly Published:
JUST OUT! EUSOBI recommends EU women be “informed” of breast density and supplemental screening considerations: Breast cancer screening in women with extremely dense breasts recommendations of the European Society of Breast Imaging (EUSOBI). Some highlights:
- “Because there is now a valid option to improve breast cancer screening, the European Society of Breast Imaging (EUSOBI) recommends that women should be informed about their breast density. EUSOBI thus calls on all providers of mammography screening to share density information with the women being screened.”
- “In light of the available evidence, in women aged 50 to 70 years with extremely dense breasts, the EUSOBI now recommends offering screening breast MRI every 2 to 4 years.”
- “Where MRI is unavailable…ultrasound in combination with mammography may be used as an alternative.”
As a reminder, DB-I-Europe was developed to support such discussions and, among other resources, features educational tools for both European patients and doctors/health providers.
Using Social Media to Educate Patients & Providers
DB-I has a robust social media program to reach and share information with both patients and health providers. Please be an educational resource! DB-I’s educational posts (nearly daily) are intended to be shared. To “follow” us, please visit DB-I pages on Facebook, Facebook/Spanish, Twitter, LinkedIn and Instagram.
Did you know that March 1st is National Pancake Day in the U.S.? DB-I had some light-hearted fun and participated on social media: