Breast Disease Society Supports Informed Patient Decision Making on Breast Cancer Screening

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The American Society of Breast Disease has issued a new statement to help physicians inform women on how breast density affects breast cancer screening and cancer risk. The statement outlines seven points which ASBD recommends as an algorithm for breast cancer screening. The following is a summary of the statement: 1. Effective screening for breast cancer is not just a single test. It is a multidisciplinary, inclusive process involving primary physicians, Ob-Gyn specialists, and their patients. 2. Due to the multidisciplinary approach to breast care, ASBD acknowledges that the various clinicians involved may have different opinions about that care. 3. The technical and scientific information related to the dense breast issue is best analyzed by medical professionals. 4. Information provided to various stakeholders should be relayed to them in their own "language." 5. Medical professionals should make recommendations and establish quality performance standards based on science, experience, and judgment. The broader marketplace of breast care should then allocate resources according to supply and demand. 6. Decision-making should be a combined effort between patients and their physicians. 7. Legislative initiatives related to medical care are reasonable actions. ASBD believes that if women know their lifetime risk, which is determined by several factors such as age and family history, and whether or not their breasts are dense, they can better understand their physician’s recommendations and make more informed screening decisions. Breast density increases lifetime breast cancer risk by about three to four times compared to women who do not have a dense breast pattern on the mammogram. For these reasons, breast density has emerged as an important criterion in breast cancer screening, and has been the subject of legislation in several states. Five states now mandate that breast density results be communicated to patients in a “patient’s results letter,” according to the press release. These states include California, New York, Virginia, Connecticut, and Texas, encompassing 30% of the nation’s women. Similar legislation is being considered in more than a dozen other states, and Congress is considering a federal law on the subject. By making breast density and lifetime risk a consideration in breast cancer screening, ASBD hopes that women will be more informed and willing to work with their physicians when making decisions about their breast care.