Women’s right to know: BCNA responds to BMJ breast density study

Breast Cancer Network Australia (BCNA) responds to the recent study published in the BMJ by Nickel et al which focusses on potential adverse outcomes associated with informing women about their breast density.

The BMJ study concluded that ‘women notified of their dense breasts felt anxious and confused, did not feel more informed to make decisions about their breast health, and wanted to be guided by their general practitioner.' It also stated that 'notification of breast density as part of population-based breast screening may have adverse outcomes, including additional consultation burden on general practitioners'.

BCNA is concerned about the conclusions drawn from this study. The suggestion that informing women of clinically relevant information about their bodies should be reconsidered because it may increase GP burden is deeply troubling. Women seeking guidance from their GP is not an ‘adverse outcome’—it is a cornerstone of safe, person-centered healthcare.

To use potential GP burden as a rationale for not notifying women of their breast density is fundamentally at odds with contemporary principles of informed consent, transparency, and shared decision-making. Withholding information to reduce pressure on the health system sets a dangerous precedent and risks undermining women’s autonomy and trust in screening programs.

BCNA strongly supports BreastScreen Australia’s policy position that women should be informed in writing of their mammographic density, and that they are encouraged to discuss with their GP how breast density affects their approach to early detection, in the context of their risk factors, personal circumstances, and preferences.

Significant national policy developments now support this approach. BreastScreen Australia’s updated Position Statement on mammographic density recommends written notification to women and is strengthened by the Australian Government’s GP Breast Density Guidance which was developed in consultation with the Royal Australian College of General Practitioners. BCNA consumer representatives contributed to the co-design of this guidance to ensure that women's lived experience shaped clear, consistent, evidence-based pathways for screening and follow-up.

BCNA will continue to advocate for transparency, equity, and informed choice - because women deserve nothing less.