Reader Question: Mammography

By  Dr. James Haroun, Director, Medical Imaging

Q: In your article Mammography - Still The Best Method for Breast Cancer Screening, you recommend annual mammograms, however the Ontario Breast Cancer Screening Protocol recommends mammograms every two years. I am just wondering why Medcan’s protocol is different?  Thank you, Karen.

A: Great question. 

The American Cancer Society currently recommends yearly mammograms for all women starting at age 40.  I can only hope that the OBSP (Ontario Breast Cancer Screening Protocol) will one day adjust their own screening protocols to be like ours at Medcan - yearly after 40!  Breast cancer is the leading cause of death for women from age 35-54, and early detection is the key to survival.   In my own practice, I have diagnosed 4 women with breast cancer in their 40's after a delay of 18-23 months from their last normal mammogram.  Each of these women had large breast cancers that most likely would have been diagnosed earlier (at a potentially more easily treatable stage) had they had a yearly mammogram (instead of bi-annual).   

Also, a new study released in December 2010 at the Radiologic Society of North America annual meeting found that the number of mastectomies necessary after breast cancer diagnosis was cut in half through programs performing yearly mammograms after age 40.  In other words, it isn't only saving lives that we are concerned about through this protocol of yearly mammograms, we are also trying to avoid more invasive surgeries.

Q: I have been told by my GP that I cannot have a mammogram paid for by OHIP because I am over 75.  Is it still necessary?  There is no history of breast cancer in my immediate family.  Regards, Mary

A: OHIP will pay for a mammogram at any age as long as it is requested by a physician. (Your physician may have meant that the OBSP program stops recalling patients for routine screen at 75, but OHIP will still cover your tests).  In general, as long as you are in good health, screening for breast cancer can continue for many more years after age 75. With respect to your personal situation, this would be best discussed directly with your physician.