Breast Cancer Foundation: Call for Mandatory Dense Breast Reporting
Dionne Scott, a 50-year-old resident of Whanganui, is advocating for more information around dense breast tissue after her own cancer diagnosis was delayed by a standard screening process.
The diagnostic delay in Whanganui
In 2024, at age 50, Scott received a breast cancer diagnosis that followed months of uncertainty. Nine months prior to her eventual diagnosis, she had undergone a routine mammogram that yielded a clear result, even though she had identified a physical lump. When the lump persisted six months later, she returned to her general practitioner and was referred for further imaging.
Neither a secondary mammogram nor an ultrasound successfully identified the cancer. Only after Scott insisted on a biopsy was the cancer confirmed. She subsequently underwent a lumpectomy, radiation, and hormone treatment. “If I hadn’t pushed and said, yeah, I want the biopsy, if I just said, okay, I’ll wait another year, I’m sure it would have been way more than grade two,” Scott stated.
The impact of dense breast tissue on screening
One in 10 women possess extremely dense breast tissue, a biological factor that renders standard mammograms significantly less effective. In dense tissue, both healthy structures and tumors appear white on a mammogram, effectively masking the presence of cancer. For these women, standard screening may only detect approximately half of existing cancers.
Vanessa Sorenson, chief executive of the Breast Cancer Foundation, notes that the current one-size-fits-all screening model fails this demographic. While mammograms remain the best screening tool for most women, they are not universally effective. The foundation argues that women have a right to be informed of their breast density, as this information is vital for understanding personal risk and exploring additional, more accurate screening pathways.
Proposed policy changes for 2026
The Breast Cancer Foundation has integrated these concerns into its 2026 Election Manifesto, urging the next government to modernize screening protocols. The proposed reforms include requiring BreastScreen Aotearoa to include breast density in every screening result, as well as the implementation of publicly funded additional screening for women identified as having a higher risk of breast cancer.
A key element of this push is the adoption of contrast-enhanced mammography (CEM). This technology utilizes an injected contrast dye to highlight areas of unusual blood flow, making tumors within dense tissue more visible to radiologists. Sorenson emphasizes that while the technology is available, the current lack of a funded pathway creates a tiered system where only those with the financial means to pay privately can access the most effective detection methods.
New Zealand screening lags behind global standards
New Zealand’s current screening policy is increasingly out of step with global practices. Mandatory breast density reporting is already federal law in the United States and is largely standardised or required across most Canadian provinces and territories. In Australia, states have been introducing reporting requirements progressively.
Professional bodies have also changed their expectations. In 2023, the Royal Australian and New Zealand College of Radiologists recommended that breast density reporting be made mandatory. Despite this professional consensus, the public screening program has yet to align its reporting standards. For women currently dealing with these gaps in care, the process often requires proactive engagement with their general practitioner to discuss individual risk profiles and the potential for private diagnostic imaging when public options are insufficient.
Future steps for screening access
The debate now centers on whether political parties will commit to funding these diagnostic improvements. Advocates argue that access to appropriate screening should be determined by clinical risk rather than a patient’s ability to pay. As the election cycle progresses, the focus remains on shifting the public screening model from a broad-spectrum approach to one that accounts for individual biological variations.
For patients concerned about their own risk factors, the lack of standardized reporting continues to present a significant hurdle. Until policy changes are enacted, those who suspect they have high breast density often find themselves needing to consult with specialized diagnostic radiologists or private imaging clinics to secure the additional testing necessary for peace of mind. The transition toward mandatory reporting will serve as the first step in ensuring that the diagnostic process is as transparent as it is thorough.