Ontario Breast Screening Guidelines

October is breast cancer awareness month, therefore I wanted to shed light on Ontario's breast screening program guidelines. Breast cancer is the most common cancer in women, and will affect many families - including mine. I am fortunate to say that my grandmother is a breast cancer survivor and now I use my voice and education to help educate women about what they can do about their risk of getting this disease. 

Of course, I will also begin with diet and lifestyle - however, it is crucial to screen yourself or get it done annually to decrease your risk.  

When does screening start?

Mammograms are recommended every two years for women over the age of 50, who have average risk. You may need a health care provider referral or self-referral (this may happen by doing a self exam). Criteria include: not experiencing any acute breast symptoms, no personal history of breast cancer, no current breast implants and no screening mammogram in the last 11 months. 

If a woman is considered high risk, mammograms start at the age of 30. Criteria include: 

• They are a known carrier of a gene mutation, like BRCA1 or BRCA2

• They are a first degree relative of a carrier of a gene mutation, that has had genetic counselling and declined genetic testing

• They were assessed by a genetic clinic as having equal or greater than a 25% personal lifetime risk of breast cancer based on their family history

• They received chest radiation before they were 30 years old, and at least 8 years before.

How often should screening happen?

For average risk women, screening happens every 2 years using a mammogram.  

For high risk women, screening happens every year using a mammogram and breast MRI/ultrasound.

Self-screening should be done every month, no matter your age or risk. 

When does screening stop?

For average risk women, screening stops at 74 years old. 

For high risk women, screening stops at 69 years old.  

How you can perform a self screen

Self breast exams should be done on a monthly basis, and be part of your annual physical exam. When you are performing them yourself, there are 3 different ways to do it - in the shower, in front of a mirror and lying down. The best time to perform one of these exams, is after your cycle (if you still experience one) as your breasts may no longer be swollen and tender. 

In the shower

Use the pads of your fingers to move around the entire area of your breast in a circular pattern. Begin from the outside breast, towards the centre. Be sure to check the entire area including the armpit, as lymph nodes reside there. You are assessing to see if there are any lumps, thickening, or hardened knots. If you discover anything, have it evaluated by your medical doctor. 

In front of a mirror

Visually inspect your breasts four different ways: 

1. With your arms at your sides
2. Ams overhead
3. Palms on your hips while flexing your chest muscles
4. Hips bent and arms towards the mirror

Your left and right breast may not exactly match (ie. one may be bigger than the other), and that's normal. What you're looking for is dimpling, puckering or any changes.  

Lying down

When you are lying down, your breast tissue will spread out evenly along your chest wall. Whichever breast you decide to check first, put a pillow underneath that shoulder and that arm behind your head. Using the pads of the fingers of the opposite hand, move the pads of your fingers around that breast in small circular motions assessing the entire breast area and armpit. 

Final Thoughts

This month we will be inundated with walks, runs, and pink products to bring awareness to the cause. I believe that many women know about breast cancer, and that the awareness is already there. I would then encourage them to start self-screening and think of ways to minimize their risk. 

I watched a documentary a few years ago called Pink Ribbons, Inc. and it helped to change the way I look at products, and it also began my journey into natural beauty and minimizing toxic exposure. 

For more information about exposure, foods and other factors that affect breast cancer risk, I really enjoyed reading this post by Meghan Telpner.

At the end of the day, it is estimated that 1 in 8 women will develop breast cancer in her lifetime. That's pretty significant! Do what you can, do reduce your risk.

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