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© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Breast density, also known as mammographic density, refers to white and bright regions on a mammogram. Breast density can only be assessed by mammogram and is not related to how breasts look or feel. Therefore, women will only know their breast density if they are notified by the radiologist when they have a mammogram. Breast density affects a woman’s breast cancer risk and the sensitivity of a screening mammogram to detect cancer. Currently, the position of BreastScreen Australia and the Royal Australian and New Zealand College of Radiologists is to not notify women if they have dense breasts. However, patient advocacy organisations are lobbying for policy change. Whether or not to notify women of their breast density is a complex issue and can be framed within the context of both public health ethics and clinical ethics. Central ethical themes associated with breast density notification are equitable care, patient autonomy in decision-making, trust in health professionals, duty of care by the physician, and uncertainties around evidence relating to measurement and clinical management pathways for women with dense breasts. Legal guidance on this issue must be gained from broad legal principles found in the law of negligence and the test of materiality. We conclude a rigid legal framework for breast density notification in Australia would not be appropriate. Instead, a policy framework should be developed through engagement with all stakeholders to understand and take account of multiple perspectives and the values at stake.

Details

Title
Breast Density Notification: An Australian Perspective
Author
Ingman, Wendy V 1 ; Richards, Bernadette 2   VIAFID ORCID Logo  ; Street, Jacqueline M 3 ; Carter, Drew 4 ; Rickard, Mary 5 ; Stone, Jennifer 6   VIAFID ORCID Logo  ; Dasari, Pallave 1   VIAFID ORCID Logo 

 Adelaide Medical School Based at The Queen Elizabeth Hospital, University of Adelaide, Adelaide, SA 5011, Australia; [email protected]; Robinson Research Institute, University of Adelaide, Adelaide, SA 5005, Australia 
 Law School, University of Adelaide, Adelaide, SA 5005, Australia; [email protected] 
 School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia; [email protected] 
 Adelaide Health Technology Assessment, School of Public Health, University of Adelaide, Adelaide, SA 5005, Australia; [email protected] 
 Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW 2141, Australia; [email protected] 
 Centre for Genetic Origins of Health and Disease, Curtin University and The University of Western Australia, Perth, WA 6009, Australia; [email protected]; The RPH Research Foundation, Royal Perth Hospital, Perth, WA 6000, Australia 
First page
681
Publication year
2020
Publication date
2020
Publisher
MDPI AG
e-ISSN
20770383
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2641067865
Copyright
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.