B.C. women can get mammograms starting at 40, so why aren’t they?

VANCOUVER – This week a U.S. health panel changed its mammogram recommendation to begin 10 years sooner. It’s something that is already happening in B.C., but few are accessing.

The U.S. Preventive Services Task Force issued a draft guidance, calling for biannual breast cancer screenings to start at age 40 instead of 50.

B.C. is one of the few provinces in Canada which allows women to request mammograms starting at age 40, but radiologist Dr. Paula Gordon said only 25 per cent of women who are eligible are doing it.

“The problem is it's not well known,” Dr. Gordon told CTV News. “The other thing is that if the family doctors would encourage it, that would help, but many family doctors are following what they think are the taskforce guidelines and encouraging women to not have mammograms even though they don't even need a doctor's requisition to go.”

Coquitlam mother Rosilene Kraft faced obstacles getting the proper tests from her family physician, who even discouraged her from getting a mammogram because she doesn’t have a family history of it.

“My family doctor said, ‘We only recommend that you do it from 50 onwards, before that, it can even be risky for you because it's exposing you to radiation,’” she recalled. “He told me to do yoga, that would help.”

After an emergency room visit and several tests later, she was finally diagnosed with stage four breast cancer, meaning it had already spread.

She was 47 at the time.

“I don't want this to happen to other people,” she said.

In Canada, breast cancer is the most common form of cancer in women and the second leading cause of cancer deaths.

Dr. Gordon said breast cancer is often more aggressive in pre-menopausal women because the most common form of cancer is a hormone-sensitive kind.

“Those hormones can act like fuel on the fire. They don't cause the cancer, but if a woman gets a cancer, they can cause it to grow faster,” she explained.

Women of colour often develop breast cancer at a younger age, so it is especially important that they get screened in their 40s, Gordon explained. She added white women, statistically, are impacted in their 50s and 60s.

“If you don't let Black, Asian and Hispanic women have mammograms starting at 40, many of them will be diagnosed later when the cancer has already spread,” she said.

Adding to the obstacle of getting properly screened, almost a million British Columbians don’t have a family doctor.

Dr. Gordon explained having a family physician isn’t necessary to access a mammogram, but the name of a health care provider is needed.

She said it can be the name of a nurse practitioner, naturopath or even the name of a walk-in clinic doctor.

She stressed early detection is vital to ensure better outcomes, and it can help the patient avoid more intrusive treatment, such as a mastectomy.

“There is a smaller operation for women diagnosed earlier where that complication is far less frequent. And finally, when a woman's diagnosed earlier, sometimes she doesn't need chemotherapy, which is a huge benefit of early detection,” Dr. Gordon explained.

She would like to see the province send out invitations for mammograms to women on their 40th birthday, something that used to be done.

Heath Minister Adrian Dix said that is something being considered.

“Our experts will work with people and the BC Cancer Agency to consider new data and perhaps expand such a program. But prevention is a big part of what we have to do in cancer care,” Dix said.

Kraft has been battling breast cancer for the last five years. She is also a patient care advocate, encouraging more people to get screened.

“They need to know their breasts; they need to know the density of their breasts and make a decision on how they're going to get their mammogram. If they have dense breast tissues, many times, they need to get an ultrasound following the mammogram and they need to know that,” Kraft said.

In B.C., mammogram screening is recommended every two years.

Since cancer tends to grow faster in younger women, Dr. Gordon believes women in their 40s should be screened annually.