Wednesday, August 31, 2011

Ontario Breast Screening Program opens door for younger women at high risk for breast cancer

By Dr. Yun Yee Chow, Radiologist, Rouge Valley Health System

Cancer Care Ontario has recently announced the expansion of the Ontario Breast Screening Program (OBSP) to include screening for women aged 30 to 69, who are at high risk for breast cancer. The funding, which went into effect July 1, 2011, provides younger women at higher risk for developing breast cancer with annual mammograms and magnetic resonance imaging (MRI) scans.

Prior to the announcement, only women 50 and over were eligible for OBSP mammography screening. Early detection can significantly improve the chances of survival once diagnosed with breast cancer. This new development is great news for women under 50 who are at high risk for breast cancer.

The OBSP was formed in 1990 primarily for screening and allowed patients to receive a mammogram without obtaining a requisition from their family physician. In effect, they refer themselves, making the service more accessible for many women. It provided an environment with quality of care assurance, Canadian Association of Radiologists (CAR) accreditation and standardized reports and reminders. The breast screening clinic’s system navigator also helps to facilitate and guide the patients through urgent surgical and cancer care referrals.

The general screening OBSP population includes women 50 years of age and older, who have no acute breast symptoms or problems, no implants, no personal history of breast cancer, and have not had a mammogram in the past 11 months.

The newly-expanded high risk program will be available initially at certain sites called OBSP Assessment Centres with a family doctor or nurse practitioner referral only.  A genetic assessment can be arranged for certain gene mutations such as BRCA1and BRCA2, which can be seen in first degree relatives such as mother, sister or child.

Rouge Valley Centenary is currently in the process of becoming such a centre, with Rouge Valley Ajax & Pickering expected to follow in the near future.  The centres will feature state-of-the-art radiologic equipment and services, while surgical and oncologic departments will be available to breast patients. Our new system navigator, Channie Mak is on hand to help guide patients through difficult and complex breast issues.

Approximately 34,000 women in Ontario are at high risk of developing breast cancer. It is expected that the stringent screening process with MRI and mammography will detect an additional 17 cancers a year for every 1,000 women screened.

For most women, genetic screening assessments will be needed to determine whether or not they are at high-risk for breast cancer. However, high-risk factors include:

  • Women who are known to be carriers of the BRCA1 or BRCA2 gene mutation;
  • Women with a first degree relative that is a known carrier of the BRCA gene mutation carrier;
  • Women with strong family history in first and second degree relatives with breast and ovarian cancer;
  • Patients who have had chest irradiation for cancer prior to 30 years of age.
Speak with your physician for more information on genetic testing.

Women at high risk have a 25 per cent or greater lifetime risk of developing breast cancer. In other words, their risk is two to five times higher than most other women. Many of these breast cancers detected in younger women are more aggressive than those seen at a later age.

Finding breast cancer early means:

  • A better chance of treating and curing  the cancer successfully;
  • A lesser chance that the cancer will spread;
  • More treatment options.
Currently the five-year survival rate for breast cancer in Ontario is 88 per cent. Mammography is still considered the screening tool of choice. Both Rouge Valley Centenary and Rouge Valley Ajax Pickering’s breast clinics feature new low-dose full-field digital mammography units, as well the capability to perform stereotactic and ultrasound guided breast biopsies. This means that our patients have access to the highest standard of breast screening care, right in their own community.

Remember that prevention and early detection are key to living a long life. If you're not sure about what screening test to arrange, or how frequently you should be screened, you can have your questions answered by a short Cancer Care Ontario self screening on- line tool here or ask your family physician.

And learn more about Rouge Valley’s mammography program here.