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A major change in the way doctors talk about mammogram results is coming soon



Photo: Damian Dovarganes (AP Images)

Doctors in the US may soon be asked to provide women with more information about their mammographic outcomes. This week, the Food and Drug Administration announced it was updating a rule that physicians should tell patients if they have dense breast tissue, a complicated risk factor for breast cancer.

Thanks to the Mammography Quality Standards Act of 1

992, the FDA has the authority to certify, regulate, and inspect clinics and hospitals where mammograms are offered. This can also be used to set standards for the provision of these services. According to the Agency, the proposed rule change would be the first large one to have gone through the pipeline for more than 20 years.

"As part of our overall commitment to protecting women's health, we propose new strategies. Modernize our oversight of mammography services by taking advantage of a number of important mammography advances, such as the increased use of 3D digital screening tools and the Need for more consistent reporting on breast density, "said soon-to-be FDA Commissioner Scott Gottlieb in a statement.

There are several types of dense breasts, but generally the term describes that it has more fibrous and / or glandular tissue than fatty tissue. It is estimated that about half of women in the US have dense breasts, with 10 percent having very dense breast tissue.

However, the relationship between breast density and cancer risk is complex. By itself, dense breast tissue is associated with an increased risk of cancer – a risk that increases the denser tissue you have. But dense tissue can also make it harder to read the results of a mammogram because its white appearance on an X-ray can look very similar to tumors and other abnormal changes in the breast.

This means that doctors are often unsure if they are not sure. A woman with dense breast tissue is actually at an increased risk. Therefore, these women tend to receive additional tests that may include other imaging techniques such as MRI or ultrasound. While this may sound harmless, it is still unclear whether additional testing for these women (especially women without a family history of breast cancer or other major risk factors) will be helpful in the vast majority of cases. In the case of false positives, this may well be an unnecessary source of stress.

In many states, doctors are already required to inform patients in advance about their breast density. However, the rule change by the FDA would set a minimal standard for reporting. This standard would require physicians to explain to their patients the complex nature of breast density. Currently, only a few states require insurers to automatically cover additional tests for this risk group.

The FDA's plan did not come out of nowhere. In February, a provision of the Expenditure Act, which further diverted the government, called for the agency to develop these standards for breast density. This was part of a long-term effort by grassroots activists that was reinforced by senators Dianne Feinstein (D-California).

Currently, the United States Preventive Services Task Force recommends that the average woman receive mammograms every two years from the ages of 50 to 74, while women at higher risk may start at the age of 40. However, the American Cancer Society generally recommends women. At the age of 45, get annual mammograms that change once every two years from the age of 55.


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