By Kathy Kaufield
A text from my friend Liz Tait of Rothesay haunts me: “I had to beg and actually cry to be given a referral for a mammogram at 40. My grandmother had breast cancer, and I watched two friends die from breast cancer so I was desperate to even have a baseline.”
Begging and crying to get a screening mammogram here in New Brunswick? This ridiculous situation must change. The lives of New Brunswick women depend on it.
New Brunswick women in their 40s are not allowed to simply make an appointment for a breast screening mammogram like they can in Nova Scotia, PEI, British Columbia and Yukon. Instead, they require a referral from a doctor. If a woman is fortunate enough to have a family physician, doctors are often reluctant to give referrals because New Brunswick is clinging to the Canadian Task Force on Preventive Health Care’s outdated, flawed and dangerous breast screening guidelines that advise against routine screening for average risk women under the age of 50. These controversial guidelines, which have been under fire from breast cancer and radiology experts for years, have recently also been called into question by the Canadian Cancer Society, Rethink Breast Cancer and the Canadian Breast Cancer Network.
Breast cancer is the leading cause of death in Canadian women 40-55 years old. Seventeen per cent of breast cancers occur in the 40s, and 17.5 per cent of breast cancer deaths come from cancers diagnosed in the 40s. Women in their 40s represent 27 percent of the life years lost to breast cancer and have the most years of life to gain when screening is performed.
Breast cancer ‘pink washing’ has conditioned many to believe this awful disease is quite treatable these days. While treatments have improved, the hard truth is: there is no cure for breast cancer and it can kill quickly. Those whose cancers are detected early have won the breast cancer lottery, so to speak. The five-year survival rate of stage 1 breast cancer is 99 per cent. Those whose cancers have spread to other body parts (stage 4) have a 23 per cent five-year survival rate.
Until there is a cure for breast cancer, we must do everything we can to help women find it early, and mammograms can detect lumps two to three years before they can be felt. Early detection of breast cancer reduces deaths as well as the need for harsh treatments, such as mastectomy, chemotherapy, and axillary dissection.
A new study conducted by Dr. Jean Seely and Dr. Anna Wilkinson of the Ottawa Hospital, in conjunction with Statistics Canada, proves irrefutably how damaging the current Canada Task Force breast screening guidelines have been. The study found that provinces like New Brunswick that don’t screen women 40-49 have significantly more advanced and metastatic breast cancer in women 40-49 at time of diagnosis. There are downstream impacts on women 50-59, who have later stage diagnoses if they are not screened in their 40s. There is increased mortality in women 40-60 when women in their 40’s are not screened.
Our province took a step forward in its breast screening program in 2020 when it started notifying women of their breast density. Women with dense breasts have an increased risk of breast cancer and their breast density makes cancer harder to detect on a mammogram. Only a radiologist can determine breast density after a mammogram. Putting up barriers to mammograms for women in their 40s not only steals their chance to find cancer early but also prevents them from finding out their breast density which is potentially lifesaving information about their own health.
Premier Blaine Higgs and Health Minister Bruce Fitch, give New Brunswick women in their 40s direct access to screening mammograms by allowing them to self refer annually. Women in their 40s are not expendable. They should not have to beg for appropriate healthcare. Access to appropriate screening should not depend on a woman’s postal code.
Our healthcare system is under immense pressure but cancer does not stop because of that. Allowing self-referral is a doable improvement to our screening program that will have a huge impact on women and the people who love them. Premier Higgs and Minister Fitch, let that be your legacy rather than being haunted by the unnecessary deaths our current screening program ignores.
Kathy Kaufield of Quispamsis is a breast cancer survivor, volunteer advocate with Dense Breasts Canada and founder of the #TellMe campaign that helped bring breast density notification to New Brunswick, PEI and Nova Scotia.
*As appeared in the Telegraph Journal, Gleaner and Times and Transcript on Jan 11, 2023