I read the recent CMAJ news article, which noted that some researchers question whether notifying people about their breast density will save lives or lead to unnecessary anxiety and testing, with disbelief and concern.1
I am a family doctor in British Columbia and in 2015, at the age of 43, I was diagnosed with breast cancer after palpating a large lump in my left breast. My only risk factors for breast cancer were being female and having dense breasts. However, I did not know my breasts were dense at the time of my diagnosis because this information was never shared with me. If I had known that my breasts were extremely dense, I would not have allowed a normal mammogram to reassure my physician and delay my breast cancer diagnosis by 3 months.
Women have the right to know their breast density, their breast cancer risks and how sensitive a mammogram is at detecting cancers in dense breasts. They have the right to make informed decisions about breast cancer screening and their own health. To reason that disclosing a woman’s breast density should be avoided to prevent unnecessary anxiety is unethical and paternalistic.
I was involved in the establishment of a breast health clinic in our community in 2017. We see more than 300 patients at the clinic each month. All patients are informed of their breast density and given information on what that means. Not one patient has ever told me that knowing her breast density has made her more anxious. Rather, I am frequently thanked for taking the time to share and explain this information. Every patient seen at the clinic is also informed about breast cancer risk reduction. This information is readily available on the websites of BC Cancer, the Canadian Cancer Society and Dense Breasts Canada. Does this information save lives? I’m not sure. Does it empower women to make informed decisions about their health? Most definitely!
After my diagnosis I was very angry to know that my breast density was never disclosed or explained me. To think that I wasn’t given this information to save me from unnecessary anxiety is even more disturbing. As a primary care physician and patient who has had breast cancer, I implore health care providers to focus on patient-centred care and informed joint decision-making when discussing breast density with their patients.
Footnotes
Competing interests: None declared.