Dear Minister,
I am writing to you today about two breast cancer screening practices in our province that are costing lives:
1. women aged 40-49 face barriers in access to breast cancer screening and
2. only a small percentage of women are informed of their breast density
Women 40-49:
In Ontario, access to breast screening mammography is limited for women in their 40’s. The Canadian breast screening guidelines state that women in this age group should be able to decide whether or not to have a mammogram. Despite this guidance, many women are unable to obtain the necessary referral for this procedure. It is important to note that 17% of breast cancers and 17.5% of breast cancer deaths occur in women in their 40's. Cancer in this age group is more aggressive, which leads to increased mortality rates.
Early detection is critical to avoiding the most invasive and highly aggressive medical care and saving lives. Studies have shown that women in their 40's who get mammograms have a 44% lower mortality rate from breast cancer than those who are not screened.
Many other jurisdictions in Canada provide women with the option to self-refer, either at age 40 or after their first mammogram.
For these and other reasons, routine screening and self-referral should start at age 40.
Breast Density:
Dense breasts increase the risk of breast cancer and the risk that cancer will be hidden by dense tissue on a mammogram. In Ontario today, only women with the densest breasts (Category D) are directly informed. Women in Category C, who also have dense breasts, are not directly informed. This creates gaps in the healthcare system that results in hundreds of thousands of women being unaware of their breast density and thus unable to have a complete and informed discussion with their physician about their risk.
Over the last three years, six provinces have begun directly informing all women of their breast density in their mammogram results letter.
Ontario should expand its direct reporting of density to include all women.
Sincerely,