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Andrew MacLean

Understanding Breast Density and the Impact of the New FDA Requirement: How Aidoc and ScreenPoint Support MQSA Compliance

Breast cancer screening plays a vital role in women’s healthcare, providing early detection that can significantly affect treatment outcomes. However, many women remain unaware of an important aspect of breast health: breast density. Recently, the FDA issued a ruling requiring all mammography facilities in the U.S. to inform patients of their breast density status. 

This article explores breast density, its implications for cancer screening, the FDA’s new rule and how Aidoc’s partnership with ScreenPoint supports clinicians in meeting these standards through the Transpara Breast Density solution.

What Is Breast Density?

Breast density refers to the ratio of glandular and fibrous tissue to fatty tissue in a woman’s breast. Density levels are categorized into four levels:

a. The breasts are almost entirely fatty.
b. There are scattered areas of fibroglandular density.
c. The breasts are heterogeneously dense, which may obscure small masses.
d. The breasts are extremely dense, which lowers the sensitivity of mammograph
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Women with “heterogeneously dense” or “extremely dense” breasts are considered to have dense breasts—a condition common in about 40-50% of women over 40.

Why Breast Density Matters in Cancer Screening

Dense breast tissue affects screening in two key ways:

  1. Reduced Visibility: Dense tissue appears white on mammograms, as do tumors, making it harder to detect abnormalities. Fatty tissue, on the other hand, appears darker, providing better contrast.
  2. Increased Cancer Risk: Studies suggest women with dense breasts are at a higher risk of developing breast cancer than those with less dense breasts, though the reasons are not fully understood.

The New FDA Ruling: What’s Changing?

As of September 2024, the FDA mandates that all U.S. mammography facilities must provide patients with information about their breast density. Key aspects of the ruling include:

  • Mandatory Disclosure: Providers must inform women if they have dense breasts and explain how density can affect mammogram results and cancer risk.
  • Standardized Language: The FDA requires consistent terminology across providers to avoid confusion.
  • Additional Screening Information: Facilities should inform patients with dense breasts about supplemental screening options, like ultrasound, MRI or 3D mammography (tomosynthesis), which may improve cancer detection in dense tissue.

Challenges in Breast Density Assessment

Historically, radiologists have visually estimated breast density, but assessments can vary widely. Studies indicate:

  • Intra-radiologist Variation: Breast density assessment can vary up to 20%1 when reviewed by the same radiologist over time.
  • Inter-radiologist Variation: Assessments can vary up to 33%1 when different radiologists interpret the same mammograms.

This subjectivity can lead to inconsistent density classifications, emphasizing the need for standardized, objective measures, particularly in light of the new FDA requirements.

Aidoc’s Response: ScreenPoint’s Transpara Breast Density Solution

In response to the need for reliable breast density assessments, Aidoc offers ScreenPoint’s fully automated, AI-driven Transpara Breast Density solution. This technology supports radiology teams in meeting MQSA compliance while enhancing assessment accuracy. Key features include:

  • Automated AI Assessment: Transpara provides an objective density evaluation, reducing variability across radiologists and over time.
  • 2D and 3D Compatibility: The solution supports both 2D and 3D mammograms, making it versatile for both screening and diagnostic purposes.
  • System Adaptability: Transpara integrates with major imaging systems, including Hologic, GE, and Siemens, enabling seamless adoption.
  • Detailed Density Metrics: The software calculates both a Density Grade score and Volumetric Breast Density, offering a comprehensive, data-driven analysis aligned with clinical standards.

What This Means for Patients and Providers

The FDA’s new ruling is a significant step forward in empowering women to understand their breast health and assess personal cancer risk. With breast density information available, women can discuss additional screening options with their providers and make more informed healthcare decisions.

For radiologists and imaging facilities, the ruling underscores the importance of adopting reliable tools that deliver consistent breast density assessments. Aidoc’s offering of ScreenPoint’s Transpara Breast Density solution supports radiology teams in staying compliant with FDA standards while enhancing the quality of patient care.

Key Takeaways

The FDA’s mandate on breast density information represents a pivotal advancement in breast cancer screening. By requiring facilities to disclose breast density, the FDA empowers women with crucial health information, encouraging proactive management.

As a leader in AI-driven medical imaging, Aidoc is pleased to partner with ScreenPoint to offer a robust breast density solution that supports radiologists and imaging centers in meeting these new standards. With a focus on accuracy, flexibility and patient care, this partnership aims to improve outcomes for women with dense breasts, ensuring they receive the information and resources they need.

Citations

1 Sprague, Conant, et. al. Annals of Internal Medicine 2017. “Variation in Mammographic Breast Density Assessments Among Radiologists in Clinical Practice”https://doi.org/10.7326/M15-2934

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Andrew MacLean