Horrible New Recommendations: Breast Cancer Screening in Canada

Elizabeth9

This was just released yesterday. This is terrible and shocking news for Canadian women and their families. How can they do this??

http://www.densebreastscanada.ca/wp-content/uploads/2018/03/Media-Release-Cdn-Task-Force-2018-Guidelines.pdf?fbclid=IwAR2E2LAdEaEBNDPbeXvEseTboPDeGTzNrMi6O5RsgCP9oH-5rWYddnlpwT0

Egads007

I think you'll find that those recommendations have been around at least since 2011....just about the time yearly pap smears were taken to every 2 years....not that it's stopped my docs from doing yearly tests and imaging. Most of my friends and family (not high risk or on tamoxifen) are still being sent for yearly mammo screening, although not for yearly Pap tests. The recommendations are for persons of average risk...any higher and you’re still sent yearly. Gotta love the Canadian government for throwing their people under the health bus to save a buck or two...have to pay for Justin’s many trips and fancy dinnerssomehow!

Elizabeth9

This is new information, updated 2018 from the original 2011 report:

https://canadiantaskforce.ca/guidelines/published-...

Please note the " no evidence" disclaimer. Also, note this does not even begin to discuss the issue of dense breasts. Many women with dense breasts are considered in the "not at increased risk" category for breast cancer, when in fact they are very much in the increased risk category.

Excerpt:

Recommendations on other screening modalities, apart from mammography:

• We recommend not using magnetic resonance imaging (MRI), tomosynthesis or ultrasound to screen for breast cancer in women not at increased risk. (Strong recommendation; no evidence)
• We recommend not performing clinical breast examinations to screen for breast cancer. (Conditional recommendation; no evidence)
• We recommend not advising women to practice breast self-examination to screen for breast cancer. (Conditional recommendation; low-certainty evidence)

Rav

It's ridiculous, the same way many other things are. Like the long waitings.

I had mammograms + ultrasound of both breasts + vaginal ultrasound (to check ovaries, uterus, etc). EVERY SINGLE YEAR.

This was BEFORE moving to Canada.

Due to ridiculous “protocols" and “guidelines" used in Canada I wasn't screened last year. Guess what? Yes, I have breast cancer that probably could have been identified one year ago.

Now I want a 3D mammogram and an ultrasound of the “good" breast in order to have at least “50% of peace of mind".

I told my GP that I want to have the screenings and I want to pay for them.

Maybe this will be an issue as well. I have the referral stating it's my choice and that I want to pay, but even so my GP said I need to ask at the screening clinic IF they will do it, as the provincial government has prohibited private exams where there will be the same exam available through MSP.

I will call the screening clinic and ask if I can get them, as a private screening.

If the answer is “no", I will cross the border and have the 3D and the ultrasound done in the US,

I guess we should start a movement (letterrs? meatings with MP? class action?) in order to press the government to review many “health guidelines", as well as treatment's timeline.

We shouldn't be dying or getting painful treatments that could be avoided, in case it was easier for us to order MRI, Pet-CT Scans, Oncotype DX, Mammaprint, etc as our neighbors easily do.

I wonder if the thread that many talk about (something like “Calling All Canadians") that can not be found anymore as it was “deleted by mistake" years ago was really deleted “by mistake"? Sorry, I don't buy it. The thread would be stored on the servers. I wonder if there were too many bad stories (not to use the word “horror stories") and the website got an order to have the thread deleted so the Canadian “picture" regarding the health system doesn't look too bad

exbrnxgrl

Rav,

There are various reasons why threads are deleted but I find it incredibly hard to believe that the owners of this web site or the moderators would have been given, no less obeyed, orders to delete a thread in order to make the Canadian health care system look less bad. I hope the mods reply, but methinks your idea is a bridge too far!

Moderators

The deletion of the Canadian thread some years back was a very unfortunate mistake by us Mods. We have since added extra measures (e.g. "are you sure" pop up boxes) to ensure this does not happen again. We too were very upset by this mistake and apologize to all those who were affected.

The Mods

Beesie

I understand and share the concerns, but are these guidelines any different than the guidelines that have been in place in the U.S. for a number of years?

https://www.cdc.gov/cancer/breast/pdf/BreastCancerScreeningGuidelines.pdf

https://jamanetwork.com/journals/jama/fullarticle/2679928

To my understanding, the new release is a guideline only, which means that doctors and patients can choose to follow a different protocol; I don't think there is anything to stop a doctor from requisitioning annual mammograms for any patient of any age if they feel it is appropriate.

For me, selfishly, my bigger concern is the lack of consideration of breast density as a risk factor (as you noted, Elizabeth) and here in Ontario, the lack of guidelines for women who have a history of breast cancer. We fall between the cracks, not being part of the general screening program (as addressed by these guidelines) because we have a history of BC, but we are also not eligible for high risk screening unless BRCA positive or if we somehow otherwise meet the very stringent 'high risk' criteria. A personal history of BC is not considered a high risk factor despite the fact that it is well established that those who have been previously diagnosed are higher risk (than the average woman) to be diagnosed again. Rav, like you, I think that those of us with a history of breast cancer should automatically get annual 3D mammos and ultrasounds. That's a level of screening that would fall in-between the guidelines for the general population and the screening that is available to those who qualify as high risk. That seems reasonable but at this point there are no guidelines to address our unique risk profiles and screening needs.