Two women whose breast cancer was missed during routine annual mammograms combined forces four years ago to launch the educational website, DenseBreast-info.org (DB-I). JoAnn Pushkin (left) serves as the Executive Director and Wendie Berg (right) as the Chief Scientific Advisor of DB-I, a resource that has been developed to provide breast density information to both patients and health care professionals. These two breast cancer survivors – one a passionate advocate for patients and the other a renowned breast imaging expert – are helping to answer the question: “Have dense breasts … now what?”
In a commentary published in Diagnostics last year, Berg and Pushkin drew attention to the confusion surrounding breast density legislation in the USA, where some states use ambiguous language such as “you may have dense breasts,” while none of the states inform women that adding ultrasound or magnetic resonance imaging (MRI) can help to detect cancer not visible with mammography. They advised, “Successful communication of the increased risk of developing breast cancer and the masking potential associated with dense breast tissue is of great importance and should be considered together with other risk factors.”
The DB-I website has four main sections: (1) for patients; (2) for health professionals; (3) legislative information; and (4) screening technologies. The patient section includes 40 questions and answers, a risk checklist, educational videos and a patient brochure. All these materials are available in both English and Spanish. The health professional section includes a flow chart to determine who needs more screening, answers to frequently asked questions and a risk model calculator. The legislative section includes a colour-coded map of the states, a detailed table that compares the states, and the recently reported national standard.
The screening technologies section has just been updated and the richly-illustrated content explains what the technology is, how it works, cancer detection rates, and highlights the benefits of each imaging modality. These include full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), both hand-held ultrasound (HHUS) and automated breast ultrasound (ABUS), breast MRI, molecular breast imaging, positron emission mammography, contrast-enhanced mammography, and software to assess breast density. Seen above left (© DenseBreast-info.org and Dr Ellen Mendelson) are three-dimensional ABUS images that illustrate two masses associated with invasive ductal carcinoma.
Last month, the DB-I website received its one millionth unique pageview, a significant milestone that speaks to the educational impact the founders have had on the field of breast cancer detection and treatment. Despite – or perhaps because of – their own travails, Pushkin and Berg are giving back to their community, and that’s something we can all admire.