Breast cancer | Women don’t have all the information

As Breast Cancer Awareness Month approaches, there is serious doubt about the importance Quebec really places on women’s health.

Annie Light
Survivor, Director of Advocacy and Education, Quebec – Dense Breasts Canada

When we compare Quebec to other jurisdictions, we see that La Belle Province ranks last in terms of optimal screening practices, with a score of 0/5:

• Possibility of making an appointment for mammography from the age of 40, without a medical prescription.
• Annual screening from 40 to 49 years old.
• All women are informed of their breast density.
• Annual mammogram for women in category D.
• Possibility of making an appointment for mammography after 74 years, without a medical prescription.

The risk of breast cancer increases significantly at the age of 40 – 17% of cancers are in women aged 40 to 49 and 17.5% of deaths come from cancers diagnosed in their forties. Four provinces (British Columbia, Prince Edward Island, Nova Scotia and Yukon) allow women to make an appointment for a mammogram at age 40 without a doctor’s prescription, and Alberta and the Northwest Territories offer this option after the first mammogram in the 40s. In Quebec, the screening program begins at age 50. The Canadian Task Force’s breast cancer screening guidelines state that women between the ages of 40 and 49 can choose to have mammograms, depending on their priorities.

Despite this directive, many women are unable to obtain a medical prescription, too often causing diagnoses at later stages.

A recent study^⁠1 by Drs. Seely and Wilkinson, in conjunction with Statistics Canada, shows that provinces that do not offer midlife screening have more cancers diagnosed at later stages in their forties and fifties. For black, Asian and Hispanic women, the peak incidence of breast cancer is in their 40s. Black women are 40% more likely to die from breast cancer than white women. Quebec ignores racial disparities.

Breast density

In Quebec, women are not directly informed of their breast density and the implications. Dense breasts increase the risk of breast cancer, and the risk of cancer going undetected by mammography. The dense tissue appears white on the mammogram, just like the cancer, creating a camouflage effect. A woman who is unaware that she has dense breasts cannot have an informed conversation with her doctor about her risk and the benefits of further screening.

Quebec is the only province where the breast cancer screening program ends at age 69 (74 in the other provinces).

The risk of breast cancer increases with age; experts recommend continuing screening as long as women are healthy. In Quebec, women over the age of 69 cannot access screening without a medical prescription, and some face a refusal from their health professional.

Lives are put at risk by policies that do not promote early detection. Even with advances in treatment, the stage and size of the tumor have an impact on survival.

If Quebec really cares about women’s health and their right to information about their bodies and their risk of cancer, serious changes are needed. It’s good to raise awareness, but we have to act.