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Mammographic density and screening

How health professionals use breast density

At present, most Australian breast screening centres do not routinely measure or record mammographic density. Mammographic density is also not routinely used in Australia to assess a woman’s risk of breast cancer.

There are a number of reasons for this:

  • Currently there is no standard practice for measuring mammographic density and predicting risk (either the risk of a cancer being masked, or the risk of developing breast cancer in the future). Although there are scores that radiologists use to rate mammographic density (such as BI-RADS), these scores depend on how radiologists interpret what they see in the mammographic image. This means that women’s mammographic density scores can vary from one radiologist to another. Because mammographic density scores can vary so much, the commonly used scoring systems are not considered reliable enough to guide screening and risk management decisions.
  • New technologies are becoming available which provide an automated measure of mammographic density (volumetric, automated tools such as Volpara and LIBRA). These technologies are considered more reliable because they are automated by a computer program and do not rely on visual estimates that may differ from one radiologist to another. However, these technologies are expensive and not yet widely available in Australia.
  • While there is growing evidence that women with dense breasts have a greater overall risk of developing breast cancer, we currently do not have enough evidence about what can be done to reduce this risk. More research is needed in this area.