ACR Weighs Pros and Cons of Reporting Breast Density to Patients

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As a greater push continues to be made to inform women about their breast density as a risk factor for breast cancer nationwide, it's important to consider a few caveats, says the ACR.

In a statement issued this week, the group took great pains to affirm its commitment to being ahead of the curve--so to speak--on advocating for "quality breast imaging." But ACR also wants people to know that breast density has an inverse relationship on mammography sensitivity; i.e., denser breasts, lower sensitivity. Putting that information in a medical report is useful information for a provider, they say, but may be less so for patients.

"While the ACR is not opposed to including breast parenchymal information in the lay summary, we urge strong consideration of the benefits, possible harms and unintended consequences of doing so," the group said in a press release.

Among its concerns are the idea that breast density assessments are not "reliably reproducible" and "may convey a false sense of security about negative mammography results" for women with fatty breasts. Additionally, the group posits that "the significance of breast density as a rick factor for breast cancer is highly controversial," and could drive additional demand for ultrasound and MRI, thereby causing a wedge issue among insured and uninsured at-risk women.

The group refers "legislators, regulatory agencies and patient groups" to "the experience in the state of Connecticut," the only U.S. state to require insurer-covered breast density screening and patient notification of breast density in mammography results, as a likely model for implementation of breast density laws.