Network News - Winter 2009/2010 (PDF 3.7Mb - Canadian Breast ...

age 50. The panel also states that breast
self-examination (BSE) does little good
and should no longer be promoted.
”The Canadian Breast Cancer
Network (CBCN), the only national
survivor-driven and survivorfocused
organization in the breast
cancer sector, does not agree with
this finding. CBCN strongly urges
provincial and territorial breast
screening programs add women from
40-49 to their screening programs and
also encourages women to continue to
practice breast self-examination.
“There are a growing number of
women who are diagnosed with breast
cancer under the age of 50 who do
not have a history of familial breast
cancer,” said Cathy Ammendolea,
president of CBCN. “In contrast to
the position of the U.S. Preventive
Services Task Force, we would like to
see Canada provide screening from age
40. We all know that the best way to
beat breast cancer is to diagnose it in
its early stages.”
”This year alone it is expected that
22,500 women in Canada will be newly
diagnosed with breast cancer. “We
want to eliminate any impediments
to regular mammography screening
for women age 40 and older,“ said
Ammendolea.
”The Canadian Breast Cancer
Network works to advocate the best
care, quick response times from our
medical system, support networks
and strategies for living with breast
cancer.”
In addition, the Canadian Breast
Cancer Foundation issued the
following statement:
“Canadian Breast Cancer Foundation
believes all Canadian women should
be able to self-refer for mammograms
starting at age 40
“November 18, 2009 - “The Canadian
Breast Cancer Foundation continues
to advocate for all Canadian women
aged 40-49 having access to the
highest standard of breast screening.
Women should be able to self-refer
for mammograms starting at age 40,”
says Beth Easton, VP Allocations &
Health Promotion for the Foundation’s
Ontario Region. “We do not
understand why the U.S. Preventive
Services Task Force (USPSTF)
changed their position on screening
mammography for women aged 40 to
49, without new significant evidence to
support such a change.”
“The U.S. Preventive Services Task
Force (USPSTF) published new clinical
guidelines on screening for breast
cancer in the general population in
the November 17th, 2009 issue of the
Annals of Internal Medicine. Those
guidelines contained several changes
from USPSTF’s previous guidelines,
published in 2002. One of the changes
concerns screening mammography for
women aged 40 to 49 years. USPSTF
now recommends against routine
screening mammography for these
women.
“Currently, Canadian breast cancer
screening programs differ across the
country. What is available to women
in one province or territory may not
be available to women elsewhere.
Provincial programs differ in their age
of eligibility and whether self-referral
is permitted. The Foundation believes
that all Canadian women should be
able to self-refer to the best screening,
regardless of where they live.
“Benefits to mammography screening
exist for women screened in their 40s,
50s, 60s and 70s. Breast cancer detected
in women in their 40s represents
16% of the total mortality from
breast cancer. The USPSTF’s report
underestimates the benefit in mortality
reduction that can be achieved by
screening women in their 40s.
“Says Easton, “While we agree that,
wherever possible, women should
discuss the potential benefits and
risks of screening mammography
with their healthcare providers
before deciding whether to have a
mammogram, we know that in the
real world, many women do not have
a primary healthcare provider, and
sometimes healthcare providers act as
gatekeepers to screening. We are also
concerned that media coverage of the
USPSTF’s announcement will lead to
undue concern among women that
mammography is more likely to harm
them than help them. Our position
is clear. Screening mammography
saves lives, including for women aged
40–49.”
“The Foundation also hopes to
clarify that the “harms” described in
the USPSTF report would be better
described as “well-known limitations”
of screening mammography, including:
• Not all breast cancers are detected
with screening mammography
Screening mammography
sometimes results in false positives
• Some cancers are detected that are
not lethal, and current screening
cannot distinguish between lethal
and non-lethal cancers
• Like X-Rays, screening
mammography does require some
radiation exposure
“Easton observes that improvements
in screening techniques are already
addressing some of these limitations,
and that women can be willing
to accept the current limitations
because they recognize that screening
mammography provides an
opportunity to detect breast cancer
earlier, when there is a better chance of
survival.
“Provincial Program, Age of Eligibility,
Access:
• BC Screening Mammography
Program, 40, Women can self-refer
• AB Breast Cancer Screening
Program, 40, Women can self-refer
• SK Screening Program for Breast
Cancer, 50, Women can self-refer
• MB Breast Screening Program, 50,
Women can self-refer
• ON Breast Screening Program, 50,
Women can self-refer
Continued on Page 27
24 Network News Winter 2009-10