The health watchdog Hiqa is to assess whether breast density should be included as part of the State’s cancer screening programme.
Women aged 50 to 69 are eligible for a mammogram every two years as part of BreastCheck, the national population-based breast screening programme.
Breast cancer was the most commonly diagnosed invasive cancer and the second leading cause of cancer‑related death among women in Ireland between 2020 and 2022.
Although high breast density is a known risk factor for breast cancer, women undergoing screening through the BreastCheck programme are not provided with this information at present.
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Dense breast tissue has more cells that can become cancerous. It can also make a scan difficult to read as any lumps or areas of abnormal tissue are harder to see.
On Thursday, the Health Information and Quality Authority (Hiqa) announced it was starting an assessment of the potential benefits of including a breast-density evaluation in the national screening programme.
The organisation said the assessment would consider whether it would be beneficial to measure, record and tell women attending BreastCheck of their breast density.
Women with dense breasts could potentially be offered additional screening tests, such as digital breast tomosynthesis, MRI, contrast-enhanced mammography or ultrasound.
Siobhán Freeney, long-time advocate for the inclusion of breast density screening in the national programme, said it was “tremendous good news”.
“It has the potential to be really transformative. Within the current cohort, international studies say 43 per cent of all women have dense breasts,” she said.
“Because you have dense breasts does not mean you have breast cancer, but you are more likely to go on to develop it.”
Freeney, from Gorey, Co Wexford, was diagnosed with stage-three breast cancer in 2015 and she believed it could have been detected earlier had she known she had dense breasts.
She said the introduction of evaluating density could result in earlier detection of cancers, better prognosis and less-invasive treatment for many women in the State.
The assessment is being carried out following a request from the National Screening Advisory Committee (NSAC) and will explore the impact on health outcomes of these potential modifications to the programme.
Hiqa said: “Depending on the findings of this assessment, further work may be undertaken to assess the economic and organisational implications of accounting for breast density in the BreastCheck programme.”
Dr Máirín Ryan, Hiqa’s deputy chief executive and director of health technology assessment, said screening was “an important pillar of public health”.
“Breast cancer screening aims to catch cancer earlier in women who do not have symptoms. This enables earlier treatment, which can reduce mortality,” she said.
“Internationally, there has been growing interest and advocacy in developing screening pathways that take account of breast density.
“Approaches that have been adopted in some countries include measuring, recording and notifying women of their breast density and in some cases offering additional imaging.”
The assessment would review international evidence to help inform a recommendation by the NSAC to the Minister for Health, Ryan said.
