Allow NB women in their 40s to self-refer for annual mammograms
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reluctant to give referrals because New Brunswick is clinging to the Canadian Task Force on Preventive Health Care’s outdated, flawed and dangerous breast screening guidelines that advise against routine screening for average risk women under the age of 50.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 for women aged 40-49. Women of that age account for 17.5% of breast cancer deaths.
- Women in their 40s represent 27 per cent of the life-years lost to breast cancer and have the most years of life to gain when screening is performed.
- Seventeen per cent of breast cancers are found in women in their 40s, and no decade of life accounts for more than 25% of cancers.
- Although breast cancer is less common in younger premenopausal women, it is more aggressive because of the presence of ovarian hormones.
Early detection is critical
Survival depends on the size of the tumor at diagnosis.
- The five-year survival rate of stage 1 breast cancer is 99%.
- Those whose cancers have spread to other body parts (stage 4) have a 23% 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. Many women can avoid chemotherapy and return sooner to productive lives in the community.
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.
New Brunswick lags behind other jurisdictions:
- Currently four jurisdictions begin screening at 40: Nova Scotia, PEI, Yukon and BC
- Alberta begins screening at 45. In Alberta and NWT, women can also self-refer after a requisition for their first screen at 40.
- Saskatchewan has committed to screening at 40 in 2024/5.
- Guidelines for Breast Cancer Screening were recently issued in July 2022 by the National Comprehensive Cancer Network (NCCN) and stress the importance of annual mammograms for all average-risk women aged 40 and older.
- The Canadian Society of Breast Imaging is the equivalent in Canada and they recommend screening starting at 40.
- Screening starts at 40 in countries such as Japan, Sweden, and USA.