Breast cancer is the most common cancer in Canadian women, affecting one in nine women in their lifetime.
The Ontario Breast Screening Program (OBSP) is a province-wide, organized breast screening program that provides high-quality breast cancer screening for two (2) groups of women:
The OBSP screens women aged 50 to 74 years who are at average risk for breast cancer with mammography every two years.
The OBSP screens women aged 30 to 69 years who are identified as being at high risk for breast cancer with annual mammography and breast magnetic resonance imaging (MRI) screening.
Sixty-one percent of Ontario women aged 50 to 74 were screened for breast cancer with mammography in 2010–2011. This means there are still many women who would benefit from regular breast cancer screening.
The OBSP recommends that all women be breast aware. Breast awareness means knowing how your breasts normally look and feel and knowing what changes to look for.
Screening tests are imperfect and cancers can be missed.
Talk to your healthcare provider today about regular breast screening.
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Screening saves lives!
Studies show that regular mammograms for women aged 50 to 74 years reduce the risk of dying from breast cancer.
Between 1990 and 2009, breast cancer mortality declined by 37 percent for women aged 50 to 74, by 37 percent for younger women aged 30 to 49, and by 31 percent for women of all ages. This reduction may be the result of increased screening with mammography, better treatments and a decline in breast cancer incidence in the early 2000’s.
Research shows that regular screening of women aged 50 to 69 years can reduce deaths from breast cancer by 21 percent.
For every 500 women screened at the OBSP, 39 are referred for further tests, and two will have breast cancer.*
Regular breast cancer screening finds cancers when they are small and less likely to have spread.
Most women (85 percent) needing follow-up tests have non-invasive procedures, such as a doctor’s visit, special mammographic views and/or ultrasound.
Breast cancer is the most common cancer in Canadian women, affecting one in nine women in their lifetime.
In 2013, it is estimated that 9,300 Ontario women will be diagnosed with breast cancer and that 1,950 will die from this disease.
Breast cancer occurs primarily in women 50 to 74 years of age (57 percent of cases).
Less than 1 percent of women in the general population are at high risk for breast cancer. It is estimated that approximately 34,000 women (aged 30 to 69 years) in Ontario are at high risk for breast cancer and are eligible for annual mammography and breast MRI screening.
The Ontario Breast Screening Program (OBSP) is a province-wide, organized breast screening program that provides high-quality breast cancer screening for two (2) groups of women:
The OBSP screens women aged 50 to 74 years who are at average risk for breast cancer with mammography every two years.
The OBSP screens women aged 30 to 69 years who are identified as being at high risk for breast cancer with annual mammography and breast MRI screening.
The OBSP screens women aged 50 to 74 years who are at average risk for breast cancer with mammography every two years.
Screening mammography every two years continues to be the best screening approach for the early detection of breast cancer in women aged 50 to 74 years who are at average risk for breast cancer.
Women eligible to be screened through the OBSP include Ontario residents who are 50 to 74 years of age and have no acute breast symptoms, no personal history of breast cancer, no current breast implants and have not had a mammogram within the last 11 months. No referral is needed; meaning that women aged 50 to 74 years of age can book their own appointments or can be referred by their healthcare provider.
From the time the program was launched in 1990 to March 2013, the OBSP has provided more than 5 million mammograms to over 1.4 million women aged 50 and older, and has detected more than 26,000 breast cancers, the majority in early stages.
All OBSP screening sites are accredited by the Canadian Association of Radiologists’ Mammography Accreditation Program.
Women are encouraged to get screened through the OBSP because organized screening offers important benefits, such as:
inviting women to participate in screening.
reminding participants when it is time for their next screening test.
notifying participants of screening results.
tracking participants throughout screening processes.
evaluating program quality and performance.
As of June 2013, the OBSP delivers services through 162 screening sites across the province, including two mobile coaches (Northwestern Ontario and Hamilton). In addition, there are 52 OBSP breast assessment affiliates that use nurse navigators and streamlined referrals to ensure a timely, coordinated approach to the assessment of breast abnormalities for clients with abnormal screen results.
Mammography is not a perfect test:
It may miss some breast cancers. Also, some cancers develop in the time between screens. These are among the reasons that regular screening is important.
Some breast cancers that appear on a mammogram may never progress to the point where a woman has symptoms during her lifetime. Therefore, some women may have surgery or treatment for a breast cancer that would never have been life-threatening.
Not all cancers found through screening can be cured.
The OBSP screens women aged 30 to 69 years who are at high risk for breast cancer with annual mammography and breast MRI screening.
The OBSP recommends that women at high risk for breast cancer aged 30 to 69 years be screened every year for breast cancer with mammography and breast MRI. Between the ages of 70 and 74 years, the OBSP recommends that women at high risk for breast cancer be screened with mammography only. Women over age 74 can be screened within the OBSP; however, they are encouraged to make a personal decision about breast cancer screening in consultation with their healthcare provider.
Mammography is the most effective screening approach for the early detection of breast cancer for most women. However, for women at high risk, breast MRI screening in addition to mammography has been shown to be the most effective screening approach.
Women aged 30 to 69 years are considered to be at high risk if they have any of the following risk factors:
They have a genetic mutation that puts them at high risk for breast cancer.
They have a parent, sibling or child who has a genetic mutation that puts them at high risk for breast cancer and have declined genetic testing.
They have a family history that indicates a lifetime risk of breast cancer that is greater or equal to 25 percent confirmed through genetic assessment.
They received radiation therapy to the chest before 30 years of age and at least eight years ago as treatment for another cancer or condition (e.g., Hodgkin’s disease).
Women aged 30 to 69 years who think they may be at high risk for breast cancer need a referral from a physician, based on their family or medical history.
The OBSP High Risk Screening Centres facilitate referrals for genetic assessment for women who may be at high risk for breast cancer (if appropriate). For women who have been confirmed to be at high risk for breast cancer, these centres offer annual screening mammography and breast MRI, and facilitate follow-up breast assessment services for abnormal screens.
The introduction of combined screening mammography and screening breast MRI for women aged 30 to 69 years who are at high risk for breast cancer has extended the advantages of organized screening to these women, thereby improving their quality of care.
Sixty-one percent of Ontario women aged 50 to 74 were screened for breast cancer with mammography in 2010–2011. This means there are still many women who would benefit from regular breast cancer screening.
Cancer Care Ontario’s (CCO’s) goal is to increase screening rates to a 70 percent participation rate for women aged 50 to 74 years.
More work must be done to reach under-screened populations and ensure that services are in place to continue to meet the growing demand for mammography. According to the 2008 Canadian Community Health Survey:
The most common reasons reported for not having a mammogram are that women did not think it was necessary, followed by women who did not get around to it.
Smokers, women with low incomes, and women who are new to Canada are more likely to have never had a mammogram.
Going forward, priorities for CCO include focusing on under-screened populations and working with our partners to develop specific strategies to ensure that more women are getting screened.
The OBSP recommends that all women be breast aware. Breast awareness means knowing how your breasts normally look and feel and knowing what changes to look for:
a lump or dimpling
changes in your nipple or fluid leaking from the nipple
skin changes or redness that does not go away
any other changes in your breasts
Most breast changes are not cancerous, but you should have these changes checked by your family doctor or nurse practitioner.
A healthy lifestyle can reduce your risk of breast cancer:
Avoid alcohol or have no more than one alcoholic drink per day.
Limit your time on hormone replacement therapy, if used. Talk with your family doctor or nurse practitioner before making any changes to your medication.
Be physically active as part of everyday life.
Most importantly, get screened. Regular mammograms, generally every two years, are the best way most women aged 50 to 74 years can reduce the risk of dying from breast cancer.
Screening tests are not perfect and cancers may be missed.
Screening may miss some breast cancers. Also, some cancers develop in the time between screens. These are among the reasons that regular screening is important.
Some breast cancers that appear on a mammogram may never progress to the point where a woman has symptoms during her lifetime. Therefore, some women may have surgery or treatment for a breast cancer that would never have been life-threatening.
Not all cancers found at screening can be cured.
The limitations of MRI for women at high risk for breast cancer include a higher false-positive rate and biopsy rate compared to mammography alone.
Talk to your healthcare provider today about regular breast screening.
