Expanding the Ontario Breast Screening Program

The Ontario Breast Screening Program now offers screening mammography and breast MRI to women aged 30 to 69 years who are at high risk for developing breast cancer.
For more than 20 years, the Ontario Breast Screening Program (OBSP) has provided high-quality breast cancer screening for women aged 50 to 74 years. The program has recently expanded; as of July 2011, the OBSP screens women, aged 30 to 69 years, who are at high risk for breast cancer.
For women like Andrea Greenfield, 39, it’s a welcome development.
“My mother, and her mother, both got breast cancer in their late 30s,” she says, “and so I’ve believed since my teens that I was at high risk for developing the disease. That’s stressful.”
Equally stressful, says Greenfield, has been the responsibility of scheduling and coordinating her own breast cancer screening appointments. “I’d have to take the initiative to go to my doctor each year, get the referral for the mammogram, make the appointment, go to my doctor for the follow-up results, and explain my family history at every step of the way. Because there were so many steps, and because the whole process was so emotionally loaded, it was very easy to put off screening.”
Now, women who are found to be at high risk for breast cancer, including younger women, can take advantage of the services provided by the OBSP. Through the program, women are reminded of their next appointment and notified of their screening results. If a screen shows an abnormality, follow-up breast assessment services are arranged and clients are tracked through to diagnosis. As well, genetic assessment is arranged for women who may be at high risk for breast cancer, if appropriate.
“The OBSP takes on a huge amount of the practical and emotional work,” says Greenfield. “It makes it much easier for women to participate in regular screening.”
Mammography continues to be the best screening approach for the early detection of breast cancer in women aged 50 to 74 years; however, it is not, a perfect test. Mammography doesn’t find every cancer, and it sometimes finds cancers that can’t be cured or that would not have needed treatment in a woman’s lifetime. But studies show that regular mammograms reduce the risk of dying from breast cancer, as they find cancers when they are small and less likely to have spread.
“Regular screening via mammography through the OBSP starting at age 50 is appropriate for most women,” says Dr. Linda Rabeneck, Vice President, Prevention and Cancer Control, Cancer Care Ontario. “However, for women at high risk for breast cancer, screening mammography combined with breast MRI has been shown to be the most effective approach. We’re pleased that the OBSP now offers combined screening mammography and breast MRI services to these women at select OBSP High Risk Screening Centres across the province.”
That’s comforting news to Greenfield. “It’s really important for women in their 30s and 40s who are at high risk to know that they can be monitored regularly and screened with the most up-to-date and effective technology.”
Women aged 50 to 74 years can book their own appointments with the OBSP, or be referred by a family doctor or nurse practitioner. Women over age 74 can be screened within the OBSP however they are encouraged to make a personal decision about breast screening in consultation with their family doctor or nurse practitioner. Women who think they might be at high risk for breast cancer should visit their physician for a referral based on their family or medical history. And women of all ages can be “breast aware” by knowing how their breasts normally look and feel, and by reporting any changes to their health care provider.
Despite the value and success of the OBSP, nearly one third of eligible women do not get screened. To encourage all women to get screened, Ontario has created www.ontario.ca/screenforlife. All Ontario women — and men — can visit the site and use the “Time to Screen” tool to find out when it’s the right time to start screening for breast, cervical and colorectal cancers, all of which can be found early, treated more effectively, and in some cases even be prevented through regular screening.
As for Greenfield, she recently learned, through genetic testing, that she does not carry the genetic mutation responsible for her mother’s and grandmother’s breast cancer. “I can’t tell you what a relief it was to get that news. But I can tell you that I’ll be registering with the OBSP the day I turn 50.” She laughs. “Okay, maybe the day after.”
To make an appointment at the OBSP site nearest you, call 1-800-668-9304 or visit www.cancercare.on.ca/obsp.