COSA 2016: Leading epidemiologists, oncologists and endocrinologists discussed the complexities of ‘dense breast’ masking tumours, mammographic density predicting cancer risk, and future directions for screening and surveillance at the Clinical Oncology Society of Australia (COSA) and Australia and New Zealand Breast Cancer Trial Group (ANZBCTG) joint Annual Scientific Meeting today.
Researchers discussed the two-fold problem of why mammographic density is associated with increased breast cancer risk while reducing the capacity of mammography to find early-stage cancers – and what can be done about it.
Professor John Hopper, an award winning epidemiologist and genetic researcher, said while there was no scientific consensus on how to report breast density and what to do with the information, there was increasing agreement about the importance of the questions we should be asking.
“We know the risk associated with mammographic density is substantial, along with the risks of ‘masking’ – the fact that mammographically dense tissue conceals tumours from radiologists,” Professor Hopper said.
“The challenge is how to get the best predictors of risk and masking, and how to translate this into clinical and population health practice.” Professor Hopper
“To do that, we need to answer a few fundamental questions. Can we obtain measures of risk at a young age that open the door for early-life interventions and better screening protocols? What are the best measures of risk and masking, based on screening images? And how might these findings be used for improved screening, prevention, and biological and genetic research?”
Professor Hopper said that while the BreastScreen Australia program was effective at detecting cancers in women aged 50 and over who are at average risk, there was potential for tailored screening for women at higher risk, once these fundamental questions had been answered.
“We all agree that consumers are entitled to information to guide informed choices on prevention, screening, surveillance and treatment,” he said. “But until we have stronger evidence and clear agreement across key disciplines, we are unable to provide consistent evidence-based guidance for women with denser breast tissue.
“We’ve also got a lot more to do before we can recommend changes to the screening program. But the evidence we present today shows we are getting closer to finding some of the answers.”
[hr] Source: COSA. Visit the COSA ASM website for more information on speakers, abstracts and scheduled presentations.