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Open AccessPerspective

Breast Density Notification: An Australian Perspective

1
Adelaide Medical School Based at The Queen Elizabeth Hospital, University of Adelaide, Adelaide, SA 5011, Australia
2
Robinson Research Institute, University of Adelaide, Adelaide, SA 5005, Australia
3
Law School, University of Adelaide, Adelaide, SA 5005, Australia
4
School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
5
Adelaide Health Technology Assessment, School of Public Health, University of Adelaide, Adelaide, SA 5005, Australia
6
Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW 2141, Australia
7
Centre for Genetic Origins of Health and Disease, Curtin University and The University of Western Australia, Perth, WA 6009, Australia
8
The RPH Research Foundation, Royal Perth Hospital, Perth, WA 6000, Australia
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(3), 681; https://doi.org/10.3390/jcm9030681
Received: 22 January 2020 / Revised: 13 February 2020 / Accepted: 29 February 2020 / Published: 3 March 2020
(This article belongs to the Special Issue Mammographic Density: Biology and Clinical Applications)
Breast density, also known as mammographic density, refers to white and bright regions on a mammogram. Breast density can only be assessed by mammogram and is not related to how breasts look or feel. Therefore, women will only know their breast density if they are notified by the radiologist when they have a mammogram. Breast density affects a woman’s breast cancer risk and the sensitivity of a screening mammogram to detect cancer. Currently, the position of BreastScreen Australia and the Royal Australian and New Zealand College of Radiologists is to not notify women if they have dense breasts. However, patient advocacy organisations are lobbying for policy change. Whether or not to notify women of their breast density is a complex issue and can be framed within the context of both public health ethics and clinical ethics. Central ethical themes associated with breast density notification are equitable care, patient autonomy in decision-making, trust in health professionals, duty of care by the physician, and uncertainties around evidence relating to measurement and clinical management pathways for women with dense breasts. Legal guidance on this issue must be gained from broad legal principles found in the law of negligence and the test of materiality. We conclude a rigid legal framework for breast density notification in Australia would not be appropriate. Instead, a policy framework should be developed through engagement with all stakeholders to understand and take account of multiple perspectives and the values at stake. View Full-Text
Keywords: breast density; mammographic density; mammogram; breast cancer screening; clinical ethics; health policy; duty of care breast density; mammographic density; mammogram; breast cancer screening; clinical ethics; health policy; duty of care
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MDPI and ACS Style

Ingman, W.V.; Richards, B.; Street, J.M.; Carter, D.; Rickard, M.; Stone, J.; Dasari, P. Breast Density Notification: An Australian Perspective. J. Clin. Med. 2020, 9, 681. https://doi.org/10.3390/jcm9030681

AMA Style

Ingman WV, Richards B, Street JM, Carter D, Rickard M, Stone J, Dasari P. Breast Density Notification: An Australian Perspective. Journal of Clinical Medicine. 2020; 9(3):681. https://doi.org/10.3390/jcm9030681

Chicago/Turabian Style

Ingman, Wendy V.; Richards, Bernadette; Street, Jacqueline M.; Carter, Drew; Rickard, Mary; Stone, Jennifer; Dasari, Pallave. 2020. "Breast Density Notification: An Australian Perspective" J. Clin. Med. 9, no. 3: 681. https://doi.org/10.3390/jcm9030681

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