White Coat, Black Art

Dense breast awareness has skyrocketed in the past year, says advocate

Public awareness about how women's breast density can affect their health has significantly improved over the last year, but there's still much work to be done, says Dense Breasts Canada co-founder Jennie Dale.

But Jennie Dale explains more women need to be actively informed if their mammograms detect high density

Dr. Paula Gordon, left, shows Cinda Lambert her mammogram and ultrasound results. (Brian Goldman/CBC)

Public awareness about how women's breast density can affect their health has significantly improved over the last year, but there's still much work to be done, says Jennie Dale.

In September, White Coat, Black Art spoke to doctors and advocates about the elevated risk of cancer associated with having dense breast tissue.

After the episode aired Dale, co-founder of Dense Breasts Canada, said her organization was inundated with people eager to learn more.

"We heard from a lot of women who had breast cancer who were diagnosed late, and who wished that they had known and been given this information," Dale told White Coat, Black Art's Dr. Brian Goldman.

"We heard from women who had no clue, had never heard about breast density and wanted to help us spread the word. We heard from physicians who weren't aware of the issue and wanted to take action and help their patients."

Jennie Dale is co-founder of Dense Breasts Canada, a non-profit group that spreads awareness about how breast density can affect women's health. (Damien Ouellette)

Dense breasts have less fatty tissue and more glandular or fibrous tissue, which appear as white on a mammogram. This makes it harder to detect cancers, which also appear white. Fatty tissue, meanwhile, shows up as dark grey on a mammogram.

Dense Breasts Canada and other advocates have been working to raise awareness of how breast density can affect women's health, because in most Canadian jurisdictions doctors weren't required to tell patients about their breast density unless the patient knew to ask about it.

Dale called the general lack of awareness on the subject "shocking."

"It's been since 1976 that's it's been known that dense breasts increase the risk of cancer and increase the risk of masking on a mammogram. And so it's just really disturbing that physicians and women are not aware of this."

In the last year, however, that's been changing.

When White Coat, Black Art first aired its episode on dense breasts, Quebec was the only province that required a woman's breast density information be given to her family doctor.

One week later, B.C. Health Minister Adrian Dix announced that all women in the province will be automatically provided breast density information with their mammogram results.

Several provinces have since followed suit with similar or varying approaches.

Dense breast tissue can obscure cancer in a mammogram image and increase a women's chances of developing the disease. (Submitted by Dense Breasts Canada)

Dale, however, says more still has to be done.

According to Dense Breasts Canada, the provinces of Ontario, Manitoba and Newfoundland and Labrador will inform women if their beast density is 75 per cent or more — and further, records of women with less than that are not recorded.

In turn, Dale is calling on the provinces to also inform women who are found to have 50 per cent dense tissue or more.

"These provinces are only informing women with the highest category of density, and so they are ignoring a significant amount of the population that has dense breasts," she said.

CBC Radio asked these respective provincial health authorities and ministries about their policies. Representatives from Manitoba and Newfoundland and Labrador did not provide an answer by publication time.

In a statement, a spokesperson for Ontario's Ministry of Health and Long-Term Care said the Ontario Breast Screening Program "defines high breast density as greater than or equal to 75 per cent dense tissue as shown on a mammogram.

"This definition is based on evidence from a systematic review of published literature which found women with greater than or equal to 75 per cent dense tissue are at an increased risk of developing breast cancer compared to women with less than five percent dense tissue," the statement continues.

Dale says her organization is also lobbying the federal government to take a similar stance to the U.S. Food and Drug Administration (FDA), which propose rules to standardize offering breast density information to everyone in the States.

"Right now there are 37 states that are informing women: they have legislation, but the FDA wants every woman in the United States to know their breast density, and we can do the same thing," she said.

Dale says the media coverage on dense breasts has connected with many women in Canada because "it's a tragic story" that many had not heard about it until recently.

"This is more than mortality. It impacts them psychologically. It impacts the entire family. It impacts them financially. You know, they have to have mastectomies versus lumpectomies, a higher risk of lymphedema, much more aggressive treatment," she said.

"It's a very sad situation that women are put into. And if women had this information then we could avoid some of those things."

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