ASO Author Reflections: Should Breast Density Influence Patient Selection for Breast-Conserving Surgery?

Excerpt

New federal legislation in February 2019 requiring breast density notification in all U.S. states in mammogram reports has increased awareness of breast density. Increased breast density has been associated with increased risk of breast cancer, decreased mammographic sensitivity, and higher risk of breast cancer recurrence.1‐3 It has been reported that women with dense breasts are less likely to have breast-conserving surgery (BCS) and are more likely to require re-excision of margins.4,5 This may be attributable to difficulty with preoperative planning due to decreased mammographic accuracy in dense breasts. However, in recent years, the adoption of “no ink on tumor” as an adequate margin, and the introduction of cavity shave margins, have led to a reduction in re-excision rates.6,7 Given the overall decrease in re-excision rates, should there be a reluctance to offer BCS for women with dense breasts? …