The Meaning of Density

For women in America, breast cancer is the second leading cause of cancer deaths following lung cancer, disproportionately affecting Black and non-Hispanic women. As of September 10, 2024, the FDA’s newest ruling is meant to increase the efficacy of mammography and patient communication: Mammography facilities must now provide each patient with a summary of the results of the exam in plain language.

Although plain language is a familiar idea, many organizations do not use it as often as they should. Mandating plain language in the new ruling is critical, as even the most crucial bits of information are useless if not understood; unfortunately, difficulties understanding breast density notifications have historically been common. According to a recent study of breast density notification outcomes in racial and ethnic minorities, a one-size-fits-all approach to inform women about their breast density may further disadvantage racial and ethnic minority women (1). Breast density notification and accompanying information should ideally be tailored and translated to ensure readability and understandability by all women (2).

An up-to-date dense breast notification would now state: “Breast tissue can be either dense or not dense. Dense tissue makes it harder to find breast cancer on a mammogram and also raises the risk of developing breast cancer. Your breast tissue is dense. In some people with dense tissue, other imaging tests in addition to a mammogram may help find cancers. Talk to your healthcare provider about breast density, risks for breast cancer, and your individual situation.”

Led by the new FDA ruling, all future breast density education efforts should prioritize the right health information being readily accessible and understandable. But beyond enforcing plain language in notifications, consensus on what to do next is lacking. After receiving their notification, women with dense breasts are advised to discuss their individual situation with their health care provider to determine which, if any, additional imaging might be indicated. While many doctors encourage women with dense tissue to consider additional tests, others say further tests could lead to unnecessary procedures. 

In the face of flawed imaging technology, too much still depends on how skilled each patient provider is and whether the patient is armed with information. Koning’s imaging solution is built with the complexities of tissue density in mind, for equitable breast health. Read about the Koning solution on our website.  

Sources:
(1) J.M.J. Isautier, S. Wang, N. Houssami, K. McCaffery, M.E. Brennan, T. Li, B. Nickel, The impact of breast density notification on psychosocial outcomes in racial and ethnic minorities: A systematic review, The Breast, Volume 74, 2024, 103693, ISSN 0960-9776

(2) FDA.gov, Important Information: Final Rule to Amend the Mammography Quality Standards Act (MQSA)