Big change for BreastScreen NSW services this month

BreastScreen NSW services will begin reporting breast density later this month, as evidence grows that this increases cancer risk.

Breast density – the ratio of fibroglandular (dense) tissue to fatty tissue – is reported in some jurisdictions, including Western Australia and South Australia. Victorian BreastScreen services have recently started reporting the measure.

BreastScreen clinics and a mobile van is available in Sydney.Credit: BreastScreen

The Royal Australian and New Zealand College of Radiologists (RANZCR) has recommended BreastScreen services include density measures since late 2023.

NSW Chief Cancer Officer, Professor Tracey O’Brien, said reporting breast density is recognised globally as best practice to help women understand their risk.

“It’s important to remember it is common and normal to have high breast density and regardless of your breast density, a free mammogram every two years remains the best way to detect cancer in its earliest stages,” O’Brien said.

It’s estimated that up to 40 per cent of women seen by BreastScreen NSW have dense breast tissue. For most, breast density reduces as they age.

Breast cancer is the most common cancer for women in NSW, causing more than 1000 deaths each year. Nearly 7000 diagnoses are expected in 2025, according to health minister Ryan Park.

“By incorporating breast density reporting into routine practice, we can have a better understanding of how breast density affects the women of NSW, contributing to better cancer outcomes for women,” Park said.

Dense tissue can reduce cancer visibility in a mammogram. Detection may be needed through additional scans, such as an MRI or ultrasound.

Age is the biggest risk factor for breast cancer – women aged over 50 account for more than 75 per cent of cases. Family history, genetic, reproductive and modifiable risk factors like diet and exercise can also increase risk.

The BreastScreen program was introduced in 1991 to provide regular free mammograms. It is jointly funded by federal and state governments and delivers more than a million scans per year.

Women aged 50 to 74 years are recommended to have a breast screen every two years, but screening is available from age 40. Indigenous women are recommended to begin screening at 40.

An evaluation of Western Australia’s BreastScreen program found it reduced breast cancer fatalities by almost half. Despite this, modelling partly funded by Cancer Council Australia in 2022 found 75,000 Australian women were expected to die from breast cancer over the next 20 years under the current age-based approach to screening.

In a recent article and a scientific paper, the Daffodil Centre’s associate professor Carolyn Nickson, with others, argued for a shift away from age-based screening to a personal risk model.

This idea and others are being considered by the federal government’s BreastScreen policy and funding review.

The BreastScreen program is for women without symptoms. Women who notice a change in their breasts, such as a lump, should see their doctor immediately.

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