On October 30, 2023, Ontario made the announcement that they would extend the eligibility for Breast Cancer screening to those aged 40-49. Beginning in the fall of 2024 women in the aforementioned age category will be able to self-refer for publicly funded mammograms through the Ontario Breast Screening Program. An amazing announcement, as an additional 130,000 mammograms will be completed annually, but as a math nerd and 41 year old Breast cancer patient, my wheels are spinning.
So, first things first- Halleluiah- because now all of my friends, my peers, my class cohort, have no excuses to ask for screening. No longer do we have to worry that we are overreacting if we feel a twinge or a bump. Not that we should in any case, but this is an incredible public health system that is under incredible pressure, I know on many occasions I have felt guilty when I have had a test, or imaging that has been negative. Did I need it? Did I take it away from someone else who needed it more? I felt exactly this recently when the onset of crazy head aches led to a CAT scan, which led to a clean bill of head health, which led to a guilty conscious that I took the test. Simply put come fall of 2024 there are no excuses not to sign up, step up, and get screened.
"Breast cancer continues to be the most common cancer among women in Canada. Although we have made great strides in improving survival rates through regular screening and early detection, lowering the self-referral age to 40 will play a critical role in increasing breast cancer survivorship for more women in Ontario. With research indicating that Black and Indigenous women are often diagnosed with more aggressive cancers at a younger age, this will also help reduce the disparities in health outcomes for equity deserving communities – ensuring that no woman is left behind."
- Heather McPherson President & CEO, Women’s College Hospital
When I had my diagnostic mammogram done in the fall of 2022, I had no prior breast imaging other than an ultrasound from 2008. Now you didn't need a whole heck of a lot of experience to see my 14cm tumour, but as we reached the halfway mark in chemotherapy it would have been a gift to have a more recent baseline of "pre cancer" to help the team understand the progression of the cancer, but more importantly to impact of the treatment.
Digging to write this article there isn't a huge amount of data on the statistics of the benefits of earlier screening. Many professionals agree that although not as common in the age 40-49, the Cancers diagnosed tend to be more aggressive in nature. Therefore, it is the early detection of those aggressive cancers that can be simply - life changing- reducing mortality and the aggressive nature of the treatment. It is also widely acknowledged that there are some downfalls, increased false positive imagery in the age group, also coupled with increased anxiety. The benefits have out won the downfalls, or politics has led to the new opportunity but either way my person (and biased opinion) is - yey!
Now to those of you worried about a mammogram and how "painful it is" I have some tough loving! A mammogram isn't the most comfortable thing, but for me it wasn't painful or damaging. I know some people have challenges, and pain, you hear the occasional horror story, but I am going to tell you this- NO MATTER how uncomfortable the mammogram is (and I think for most not at all) CANCER IS PAINFUL. Not just a little bit of pain, not a few minutes, hours, or days of feeling uncomfortable, but life changing discomfort. So now the government has made this change I beg each of you who resides in Ontario to take advantage of the offer, step up, sign up, and have your boobs imaged.
"I am beyond thrilled by the Ontario Government's Announcement to lower the Breast Screening Age to 40. The expansion of including women ages 40-49 will empower women to make informed decisions about how best to protect their health. As a Breast Cancer Survivor, I am reminded of the physical, emotional, and psychological impacts of this disease daily. If you are a woman in your 40s, I strongly encourage you to get screened. Early detection saves lives."
- Jennifer Quaid Patient Advocate
Based upon information shared in the Ontario Newsroom Release, Ontario connecting More Women to Breast Cancer Screening Earlier, the Ontario Breast Screening Program (OBSP) currently performs 700,000 mammograms annually, via its 241 sites across the Province. The addition of the 40-49 age group will add an additional 130,000.
And this is where I start to do some basic math.
If it is a universally accepted statistic that around 1 in 8 women will be diagnosed with Breast Cancer. Drawing the simplest of conclusions does this mean some where in the region of 16,000 women are like me, living with Breast Cancer and they don't know it? Now again I must reiterate that I would have given anything to have found my Cancer sooner. To turn back the clock and have some other sign. To undergo a more simplistic treatment plan. To bluntly, have better odds of survival. All of which are the benefits of the new program. But I have to stop and think for a moment- are we ready for what this means?
We need to be ready; we will embrace the news, rally and support one another, but as I write this, I can't help but be the realist to say we are going to be undertaking a huge emotional and physical journey. Now I know my math is flawed- and I hope that statistically as we screen younger groups that the percentage of those with a positive diagnosis drops, but we can't help but accept it's about to get real, and not all news will be good news. Maybe this combination of thoughts is driven by the fact I fall into that age group, maybe because I was ignorant to my Cancer, and maybe because I am a little bit terrified for those about to receive the same news. In all of this I must remember that, quoting directly from the news release, "When found early, many people survive breast cancer, with a 100 per cent, five-year relative survival rate for those diagnosed at stage 1. However, the survival rate drops to less than 30 per cent for those diagnosed at stage 4. Early detection is critical."
There it is, in black and white, the simple reason for early screen, is early diagnosis, because I look forward to the day that a Breast Cancer diagnosis doesn't strike fear into the receiver. As I read and researched, sharing my thoughts the most shocking was a quote from Charmaine Williams, Associate Minister of Women's Social and Economic Opportunities, where she states, "nothing can devastate a family or a career like a breast cancer diagnosis." Now I have to disagree, I think there are many things that can cause devastation, but it hits a very raw emotion as I think about my own return to work. What will that look like? How much can I physically handle (fatigue is real folks)? How much can I cognitively or emotionally process (chemo brain is also very real)? How will people perceive my time away from work, and my return to work? Will I be judged because I had Cancer? It's ironic that these were many of the same thoughts I had when I gave birth to Izzy and returned to work, and they are questions I am yet to have answers.
"Supporting Ontario’s women as they continue to build our province is my top priority. We know that nothing can devastate a family or a career like a breast cancer diagnosis. That’s why we’re expanding access to care and getting women the early mammogram tests they need, so that they are empowered by better and earlier healthcare outcomes."
- Charmaine Williams,
Associate Minister of Women’s Social and Economic Opportunities
I certainly feel like this post is one that meanders through my thoughts, a reflection of excitement and fear as I;
- celebrate earlier breast cancer screening for my peers, my people, the 40–49-year old's, in the middle of their careers, with younger families, aging parents, financial responsibilities, bucket lists, and goals
- fear of what's to come as I prepare to support those folks who are about to have their lives changed forever
- concern of the knock-on effect, the impacts on the system, the ability to deliver the existing incredibly high-quality standard of care, not to mention, can we deliver on the promise of the 130,000 additional mammograms a year?
- Hope, that early detection means that the cancer journey I have shared, isn't the journey of others, where the drugs I am taking to prevent reoccurrence, are used in the earliest of stages to prevent rather than cure
- Drive to ensure that screening such as this occurs beyond the Ontario borders
At 40 I was diagnosed with Cancer, at 41 I finished the intense components of my treatment, and at 42 I look forward to herding my friends to be some of the first to get their mammograms under this program.
Find the original Ontario News Room Release, Ontario Connecting More Women to Breast Cancer Screening Earlier here;