United States Preventive Screening Task Force Guidelines Put Women with Dense Breast Tissue at Greater Risk for Undetected, Potentially Aggressive Breast Cancers
Woodbury, CT. (January 14, 2016): U.S. Preventive Services Screening Task Force (USPSTF) final breast screening guidelines place all women and especially those with dense breast tissue, about 40% of American women, at greater risk of having cancerous tumors go undetected. Furthermore, despite decades of research, USPSTF fails to acknowledge the significance of the fact that dense breast tissue can hide cancerous tumors, making them difficult to detect on mammography alone. Empowered with knowledge about breast tissue density and other risk factors, equip women for shared decision making with health care providers about their personal preferences for adjunct screening.
"By not disclosing dense breast tissue to a woman denies her shared decision making with physicians about her personal screening surveillance. And although the USPSTF report concludes that mammography is limited in dense breasts and added screening finds invasive cancers invisible by mammography, by not making a recommendation for disclosure and an opportunity for adjunct screening, it denies women access to this important health information. Invasive cancers are not just a nuisance; they can kill,” asserts Nancy M. Cappello, Ph.D., director and founder of the nonprofits Are You Dense, Inc. and Are You Dense Advocacy, Inc.
Moreover, USPSTF guidelines place a particular burden on women in their 40s, as it recommends that biennial screening begin at age 50, despite acknowledging that most lives will be saved by starting at age 40. Younger women have a greater likelihood of aggressive cancers. "To deny women under 50 access to mammography screening, because of its limitations in detecting cancer in dense breasts, and, in turn, access to adjunct screening, is preposterous," adds Cappello. "Having no screening puts younger women at a higher risk for a later-stage disease."
In addition, evidence indicates that women who are post menopausal and continue to retain their dense breast tissue, are also at greater risk of breast cancer than the average population. Studies have concluded that high breast density increases the risk of breast cancers that have a relatively poorer prognosis. Furthermore, women who are given all the facts about the causal and masking risk of dense breast tissue are empowered to fully participate in decisions regarding mammography screening and supplemental screening.
“Women have a right to access health information that affects them,” states Cappello. “Appropriate screening, discussed between physician and patient, is critical for women’s health. When screening for breast cancer, dense breast tissue is not something to be ignored.”
Congress passed the Protecting Access to Lifesaving Screenings Act (PALS Act) in December 2015 which placed a two-year moratorium on USPSTF breast cancer screening recommendations out of concerns that mammography coverage at no cost might be at jeopardy.
Currently, 24 states have legislation requiring the disclosure of dense breast tissue through the mammography report. In the remaining states, notification is voluntary. In 2016, another 8 to 10 states have or will introduce density reporting legislation. Additionally, a federal bill is pending in Congress in both the House and the Senate.
Access Full USPTF Report HERE
Dr. Cappello’s Blog Post: USPSTF gets a D for being Dense
Dr. Cappello’s Blog Post: The Collateral Damage of Being at Average Risk and Having Dense Breasts