The Australian Breast Density Consumer Advisory Council (ABDCAC) has published a consumer-authored Perspective in ecancer calling for a nationally consistent approach to breast density notification and clear pathways for women and health professionals to act on the information. The paper proposes seven practical actions spanning policy, health promotion, clinical pathways, equitable access to imaging, research, and alignment with national cancer strategies.

“Breast density is common and clinically important, it increases breast cancer risk and can hide cancers on a mammogram. Informing women, in plain language, means they can decide what’s best for their breast health,” said Dr Sandy Minck, lead author and ABDCAC member. “This is about informed decisions and consistent, easy-to-follow pathways – where you live shouldn’t determine what you’re told or what options you have.”

The paper has been published following updates to the BreastScreen Australia position statement on breast density in May this year that now mandates breast density reporting, as well as new clinical guidance for GPs published by the Australia Government Department of Health, Disability ad Ageing in November. Despite this, there are still inconsistencies in how breast density is reported between different states.

Gerda Evans, co-chair of the Australian Breast Density Consumer Advisory Council and a member of InforMD, said guidance for GPs on managing women notified of their breast density has been inconsistent, particularly regarding follow-up actions and timing of risk assessments. "We acknowledge the challenge this has caused and support the national guidance to assist GPs in providing nationally consistent information to women to enable them to make informed decisions aligned with their values and circumstances," Ms Evans said.

The authors called for national and consistent reporting using Breast Imaging Reporting and Data System (BI-RADS) categories and information about the implications of dense breasts. The need for culturally appropriate resources and public awareness campaigns on breast density and other risk factors were also proposed. The authors highlighted a need for accessible clinical pathways to provide supplemental imaging when recommended, including improved access to imaging tools such as tomosynthesis (a type of 3D mammogram), ultrasound, contrast enhanced mammography (CEM) and magnetic resonance imaging (MRI).

The Consumer Advisory Council also emphasised that ongoing research should engage consumers as partners and future approaches should align with the Australian Cancer Plan and related national frameworks.

“Notifying women about density is a practical step that supports better conversations about risk and early detection,” said Associate Professor Jennifer Stone, academic co-chair, co-author and InforMD member. “A consistent, evidence-informed national approach can lift screening quality and confidence.”