Advocates hope Alberta will follow new guidelines, lower breast cancer screening age to 40
Earlier screening can speed diagnosis, improve prognosis and save money, experts say
UPDATE: The Canadian Task Force on Preventive Health Care released its national breast screening guidelines on Thursday, May 30, 2024. It does not recommend women under 50 to get regular screenings for breast cancer, but if a woman wants a mammogram, they should be able to get one.
Sundas Shamshad was 29 when she noticed a lump in her breast.
None of the women in her entire family had ever had breast cancer. And Shamshad — who was close with her cousins, aunts, and even her grandmother's sisters — knew her family history well.
When the Fort McMurray woman first reached out to her doctor in 2017, he assured her that nothing was wrong, citing her age and the lack of family history. But Shamshad was adamant.
"I was like no, something is wrong. It was this gut feeling," she recalls.
Her gut feeling was correct. After finally undergoing breast screening and a biopsy, the results revealed breast cancer.
Currently in Alberta, women aged 45 and older can self-refer for a mammogram. Other forms of breast cancer screening, including a clinical exam or an MRI, require a doctor.
Last week, the Canadian Cancer Society sent out a public statement urging provinces and territories to lower the self-referral age to 40. Anyone younger than that would need a doctor's referral — which, as Shamshad experienced, isn't always easy to get.
In Canada, one in eight women is expected to be diagnosed with breast cancer in their lifetime, according to the society.
'It's critical that we do this'
Dr. Tracey Hillier, a diagnostic radiologist and associate professor at the University of Alberta, says it's important to change these guidelines — and for women to hear the message.
"We can save the most lives when we start breast screening at age 40 and it's critical that we do this," she told CBC's Edmonton AM on Thursday.
She cited a study published in the Canadian Association of Radiologists Journal in April, that found rates of breast cancer in Canadian women in their 20s and 30s are up compared to 30 years ago.
Women of African, Asian and Jewish descent should start screening at 30, she added. "Right now, the guidelines are not equal to keep everyone safe," she said.
In addition to earlier diagnosis and treatment, early breast cancer screening can also save money.
Research coming out of the University of Ottawa suggested that because there are less-expensive treatments available for early-stage cancer, lowering the screening age to 40 could have huge savings for the Canadian health-care system.
Andrea Smith, press secretary for Alberta's minister of health, said after an extensive review, the province lowered the eligibility to self-refer from age 50 to 45 in October 2022.
"Based on the current evidence that underpins the [Alberta Breast Cancer Screening Program's Clinical Practice] guidelines, routine screening for breast cancer has not been considered for average-risk women aged 40 to 44," she wrote in an email.
Smith said Alberta will continue to monitor "activities associated with lowering the recommended age."
The recommended age for breast cancer screening varies between provinces and territories. Most have already lowered the age to 40, or have indicated an intention to do so. Manitoba and Quebec still recommend screening at age 50, while Nunavut does not have an organized self-refer screening program.
Shamshad, who is now cancer-free, wants to raise awareness among women to advocate for themselves when it comes to their health.
She said her determination was what got her the doctor's referral that led to an early diagnosis and treatment.
"It is quite difficult sometimes because we do trust our medical professionals," she said, adding that this is why it's important for guidelines to be updated so doctors would follow them and women wouldn't need to push for referrals.
"If I had waited for, I don't know, a couple of months or maybe a year to get the screening done, I would have had a different outcome," she said.
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