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SBI Gold Medalist and UK Parliament Update

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Gold Medalist

Congratulations to Dr. Wendie Berg, DBI’s Chief Scientific Advisor, for being named SBI’s 2026 Gold Medalist! The honor is in recognition of her exceptional and significant contributions to the subspecialty of breast imaging, including leading ACRIN 6666, validating and standardizing screening ultrasound and showing the far superior cancer detection from screening MRI in women at elevated risk with dense breasts.  Dr. Berg continues to evaluate technologies that improve early cancer detection, focusing now on contrast-enhanced mammography.  She has also led a trial demonstrating complementary performance of MRI and dedicated breast positron emission mammography in assessing disease extent. She is a scholar who co-edited three editions of Diagnostic Imaging: Breast and its online component, StatDx.  Finally, she is recognized for helping launch and maintain our educational efforts at DenseBreast-Info.org.

UK Parliament Update

DBI’s European Education Coordinator Cheryl Cruwys reports that a recent Parliamentary “Drop-In” event, held to lobby for increased investment in breast screening, was a great success. The event saw strong attendance and engagement from Members of Parliament (MPs), breast cancer experts, patients, and the press. Their collective support underscores the growing recognition of the need to improve breast screening services. Building on this momentum, additional drop-in events will be scheduled for 2026.

Federal Insurance Bill Re-introduced + News Efforts and Materials Abroad

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The Find It Early Act

The federal insurance bill, the Find It Early Act, has now been re-introduced in both the House and Senate. DBI has been closely involved in the bill’s development, introduction, and ongoing progress. [Fun fact-the bill’s title was inspired by DBI’s #FindItEarly tagline.] Once the House bill is formally numbered (Senate version is S1410), DBI will again organize a Statement of Support from national medical societies, advocacy groups, and health systems. Stay tuned!

 

Australia: Breast Density Information for GPs

BreastScreen Australia has introduced Breast Density Measurement, Reporting, and Guidance for Health Professionals to help women understand breast density measurement, reporting and screening considerations and to increase their confidence in the breast screening program. For information about awareness and education efforts in Australia, please visit information forum InforMD.

 

New Study

In a study using prior negative mammograms from 524 women who developed interval breast cancer in the UK, among a total of 134,217 negative mammograms, Mirai deep learning software could identify women at risk for interval cancer 1-, 2-, or 3-years later.1  Accuracy was not affected by patient age or breast density.  Specifically:

  • The highest 1%, 5%, 10%, and 20% of three-year risk scores predicted 3.6%, 14.5%, 26.1%, and 42.4% of women who developed interval cancer.
  • Of 469 women with interval cancer and breast density information, 285 (60.7%) developed in those with dense breasts, and 37.8% of women had dense breasts.

Use of Mirai software may improve recognition of some women who may benefit from supplemental screening after a negative mammogram distinct from those with dense breasts alone, but only the minority of women who developed interval cancer would have been selected based on the top 20% Mirai risk.  Women with extremely dense breasts had similar risk of interval cancer as those in the top 20% Mirai risk.  It is unclear how the combination of heterogeneously dense breasts plus other risk factors would have performed, as is used in many breast centers in the United States.

1 The area under the receiver operating curve (AUC) was 0.72, 0.67, and 0.67 for years 1, 2, and 3, respectively (P ≥ .63).

Michigan Insurance Bill + Cheryl Cruwys Goes To Parliament

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New State Insurance Bill

Michigan has introduced a bill to eliminate out-of-pocket costs for supplementary and diagnostic breast imaging. HB 5205 bill draft available HERE.

UK News: Lobbying Event in Parliament

European Education Coordinator Cheryl Cruwys has organised a lobbying event at the Houses of Parliament on Wednesday 19 November.  Also attending is Professor Fiona Gilbert, Department of Radiology, University of Cambridge, and honorary consultant radiologist at Addenbrooke’s Hospital, who led the UK BRAID study.  The aim is to highlight the need for change and to obtain Declaration of Support signatures for investment to improve the breast screening programme to benefit women.

New FREE Credit Opportunity and European Education Coordinator Outreach

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New FREE Credit Opportunity

Breast density matters—and understanding its impact is critical for delivering personalized, high-quality care in women’s health. DenseBreast-info has just launched an on-demand CME (AMA)/CE (ASRT) activity, Dense Breasts, Risk, and Supplemental Screening. In this video-based course, our experts Dr. Wendie Berg and Dr. Robin Seitzman provide a comprehensive update on the science, guidelines, and communication strategies every women’s health provider needs to know. Please share this resource with colleagues.

Europe / UK Education

DBI’s European Education Coordinator Cheryl Cruwys lectured  University of Salford diagnostic radiography students on dense breasts, including an overview of DBI website healthcare professional resources.

Wisconsin Op-ed, UK Education, Study on False-Negative Mammograms

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U.S. State Insurance Bills

DBI’s work on individual state insurance bills for expanded breast imaging coverage continues. Executive Director JoAnn Pushkin’s op-ed in the Milwaukee Journal Sentinel details why the proposed Gails’ Law, inspired by Wisconsin patient advocate Gail Zeamer, should advance and why it matters. For details on existing individual state insurance laws for expanded breast imaging, see the DBI MAP.

Europe / UK Education

DBI’s European Education Coordinator Cheryl Cruwys was invited by the University of Suffolk to lecture diagnostic radiography students on dense breasts, including an overview of DBI website healthcare professional resources.

New Study

From over 32 million screening and over 6 million diagnostic mammography records from 2010-2022 in the National Mammography Database, Oleyumi et al. evaluated false negative rates (FNR) at one year and associations with facility and patient factors.  FNR was 1.9/1000 and 4.0/1000 for screening and diagnostic mammograms, respectively. Though interval cancers found by supplemental screening were included among false negatives and could not be distinguished from those found due to symptoms and linkage to tumor registries was mostly lacking, there were several interesting observations:

  • The likelihood of a false-negative mammogram was highest for women with a personal history of breast cancer.1
  • Women with scattered fibroglandular density, heterogeneously dense, or extremely dense breasts were each more likely to have a false negative mammogram than women with fatty breasts.2
  • The likelihood of a false negative mammogram was higher among White women compared to women of other races.3
  • False-negative mammograms were more likely among academic facilities compared to community hospital-based facilities.
1 For women with a personal history of breast cancer compared to those without, the odds ratios (OR) were 3.69 (95% CI 3.61-3.76) and 7.82 (95% CI 7.58-8.06) for screening and diagnostic mammography, respectively.
2 For screening mammography, ORs were 1.60 (95% CI 1.53-1.67), 2.00 (95% CI 1.92-2.09), and 1.82 (95% CI 1.71-1.93) for scattered fibroglandular density, heterogeneously dense, and extremely dense breasts compared to fatty, respectively.
3 For screening mammography, ORs were 0.48 (95% CI 0.42-0.56), 0.89 (95% CI 0.95-0.94), 0.85 (0.82-0.88) and 0.30 (95% CI 0.26-0.34) for American Indian/Alaskan Native, Asian, Black, and Hawaiian vs. White women, respectively.

New European Medical Supporter, Just Published

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New European Medical Supporter
DenseBreast-info/Europe announces our new European Supporter Dr. Fleur Kilburn-Toppin. She is a Consultant Breast Radiologist and Director of Breast screening at Cambridge University Hospital, UK. She is also on the Executive Board and Chair of the Educational committee for the European Society for Breast imaging. Her research interests are on a variety of aspects of breast imaging including breast density.  Welcome!

Just Published
Gordon et al reported an audit of biopsies prompted by technologist-performed handheld screening ultrasound (US) in women with dense breasts in British Columbia.  Women received either annual or biennial digital 2D mammography, with screening US midway in the interval.

  • Screening US significantly increased the rate of biopsies performed.1
  • Screening improved cancer detection2, most of which were early breast cancer.3
  • The majority of women with US-detected cancer had heterogeneously dense breasts4and half had no other risk factors.
  • Recall rates could not be assessed.

In Canada, 12 of 13 provinces have screening mammography programs. Screening US is currently available only by request in 5 of 12 provinces. The yield of screening US in this study was much higher than in a prospective study in the USA with concurrent annual tomosynthesis.

1 Among a mix of 5257 incidence and prevalence screening US examinations, 247 (4.7%) women had biopsy prompted by US.
2 32 cancers were identified in 32 women, for an incremental cancer detection rate of 6.1/1000 and PPV3 of biopsies of 32/281 (11.4%) at the lesion level.
3 Of the 32 cancers, 26 (82%) were invasive with mean size 13 mm (range 5 to over 40), and 24/26 (92%) were node negative. 
4 Of the 32 women with US-detected cancer, 27 (84%) had heterogeneously dense breasts and 5 had extremely dense breasts.

ECR Meeting, CEM/MRI Reader Study

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European Congress of Radiology
DenseBreast-info.org/Europe will be attending ECR2025, (Feb 28 – March 2) in Vienna. Both DBI’s European Liaison Dr. Athina Vourtsis, and Education Coordinator Cheryl Cruwys, will be on hand. Dr. Athina Vourtsis’ lectures include a workshop session on 28 February, 14.15 – 14.45, “Rethinking breast cancer screening strategies in resource-limited settings.”

Please visit the DBI/Europe team in the Austria Center, Level 1 at the ESR Patient Advisory Group booth. 

New Reader Study
A blinded reader study from the University of Vienna compared conspicuity (relative enhancement of a lesion compared to surrounding tissue) of enhancing breast lesions between contrast-enhanced mammography (CEM) and contrast-enhanced MRI. The study included 462 suspicious lesions (160 malignant) in 388 women who had both exams.

Results showed:

  • MRI lesion conspicuity was better than CEM for both mass and non-mass lesions.
  • MRI conspicuity was better than CEM for malignant1 and, especially, benign lesions.

The lower conspicuity of benign lesions on CEM could be beneficial in reducing false positives in clinical practice.  The authors concluded that MRI was superior for lesion detection, but that CEM remains a valuable tool, especially when MRI is not available.

1Of the 160 cancers, 2 (1.3%) cancers were not seen on MRI and 24 (15%) did not enhance on CEM, but the authors did not state if any cancers were not seen on CEM after considering low-energy images.

EUSOBI Updated Guidelines, Insurance Laws, NYT Article

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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.

ECR Meeting, New MAB Member

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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).

JBI Open Access Article, UK Celebrity Supporter

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JBI Article – Now Open Access
Article Implementing the National Dense Breast Reporting Standard, Expanding Supplemental Screening Using Current Guidelines, and the Proposed Find It Early Act is now available as open access. The FDA’s density reporting requirement goes into effect on September 10, 2024. Letters will tell women if their breasts are “dense” or “not dense.” Implementing appropriate supplemental screening should be based on patient risk for missed breast cancer on mammography; such assessment should include consideration of breast density and other risk factors. Many women with dense breasts meet current criteria for “high-risk” screening and should be recommended for screening MRI. This article discusses strategies for implementation and simple “back-of-the-envelope” guides to help identify women at high risk. Please share the article with colleagues and on social media.

UK News – Celebrity Supporter
In a national UK TV appearance, Julia Bradbury, TV presenter/journalist/celebrity, talked about her dense breasts and missed-cancer-on-a-mammogram experience: https://x.com/5_News/status/1747700392345862533?s=20. Julia’s social media posts that followed directed viewers to DenseBreast-info.org/Europe and resulted in an amazing response! Over 121.8K views, 9,404 likes and 1,026 comments. About 100 women contacted Cheryl Cruwys, DBI’s European Education Coordinator, for more information. We thank Julia, who is passionate about raising dense breast awareness!

 

 

Updates in the U.S. and Europe

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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.

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 DBI/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 DBI/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 DBI 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:
DBI 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.”

 

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.

Europe/EFRS Update and Looking Toward 2021

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The European Federation of Radiographers Societies joins many other European groups sharing/linking to DenseBreast-info.org education resources for members. Learn why EFRS leadership feels it important that providers understand the screening implications of dense tissue HERE.

Our Condolences:
DenseBreast-info.org, the entire breast imaging community, and women worldwide are profoundly grateful to Dr. Lawrence Bassett for his decades of significant contributions to every aspect of breast imaging: quality assurance, standardized reporting, education, scholarship, and friendship. We mourn his unexpected passing on December 14, 2020.

This has been a trying, challenging year on many fronts. We thank you for your ongoing support and for your continued focus on women’s breast health during a global pandemic. We send every wish for a peaceful holiday season to you and your family and our hopes that 2021 brings only blessings.