|Date of diagnosis:|
|Age at time of diagnosis: |
Stage of diagnosis:
|Last 'NORMAL' Mammogram: May, 2017|
How was cancer diagnosed: Jean felt a lump/followed by ultrasound
Jean's Story: As Jean’s husband I’m writing this story on her behalf. Jean is still progressing through treatment and not yet ready to write about her experience. Nevertheless we are sufficiently concerned about the breast density reporting issue that we are keen to get her story out there without delay.
While watching television one night Jean felt a lump in her right breast. An ultrasound, a diagnostic mammogram and a biopsy later and we found that Jean had an invasive ductal carcinoma. Less than five months previously she had received a screening report indicating that her mammogram was all clear.
The diagnostic x-rays also showed that Jean has dense breasts – in the range 50 to 75%. She had not previously heard of dense breasts and despite having nine screening mammograms over the past eighteen years she was never told that her breasts are dense.
Jean’s two most recent screening mammograms were May 2015 and May 2017. Given the size and grade of Jean’s cancer the surgeon estimated that she had had a tumor for at least three years. The implication is that both of these breast screens had returned false negatives, i.e. the cancer was present but not detected. The tumor was probably a Stage 1 in 2015.
Jean underwent a lumpectomy operation one week after diagnosis - three tumors, the largest being nearly 3 cm in size. Jean has now completed her four cycles of chemotherapy and will commence six weeks of radiation later today.
At our request BreastScreen Australia compared Jean’s diagnostic mammogram with the previous three screening mammograms going back to 2013. On the May 2017 mammogram a potential abnormality can be seen in the area of Jean’s cancer. At the time, neither radiologist thought it sufficiently significant to warrant a follow up.
Had Jean been told that her breasts are dense and that, as a result, there is a substantially reduced probability of detecting cancer through mammography we would certainly have funded supplemental MRI screenings ourselves.
Our research shows there have been complaints about the breast density reporting policy in Australia going back to 2003 at least. We are currently engaged with the relevant state and Australian Government health ministers and the college of radiologists in an attempt to get a change to BreastScreen Australia’s current policy.
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Breast density is one of the strongest predictors of the failure of mammography screening to detect cancer.
Two-thirds of pre-menopausal women and 1/4 of post menopausal women have dense breast tissue.
Adding more sensitive tests to mammography significantly increase detection of invasive cancers that are small and node negative.
American College of Radiology describes women with "Dense Breast Tissue" as having a higher than average risk of Breast Cancer.
While a mammogram detects 98% of cancers in women with fatty breasts, it finds only 48% in women with the densest breasts.
A woman at average risk and a woman at high risk have an EQUAL chance of having their cancer masked by mammogram.
Women with dense breasts who had breast cancer have a four times higher risk of recurrence than women with less-dense breasts.
A substantial proportion of Breast Cancer can be attributed to high breast density alone.
Cancer turns up five times more often in women with extremely dense breasts than those with the most fatty tissue.
There are too many women who are unaware of their breast density, believe their “Happy Gram” when it reports no significant findings and are at risk of receiving a later stage cancer diagnosis.