When Toronto resident Elysia Bryan found a lump in her right breast in the summer of 2020, she hoped it would disappear on its own.
At 34, Bryan was an active and healthy person, and did not immediately book an appointment to get screened for breast cancer.
“It was visible, so very hard to ignore. And it was painful. But I kind of thought if I ignored it, it would go away,” Bryan said.
Bryan said she ignored the lump for months. Finally, in April 2021, she went to her family doctor, who said she needed a mammogram and a biopsy. Through that biopsy, she was diagnosed with breast cancer at St. Michael’s Hospital and had a lumpectomy with two weeks.
Now, after undergoing eight rounds of chemotherapy, 24 sessions of radiation, a genetic test, mastectomy and reconstruction, she is cancer free and has become an advocate for breast cancer screening.
“If it’s detected earlier, there’s a better chance it can be treated. And it’s really when you wait and it’s detected at later stages that there are less options,” Bryan said.
Bryan works with The Olive Branch of Hope, an organization that supports Black women with breast cancer, and says she’s meeting more and more young women getting diagnosed with breast cancer.
“I really think it’s important that young women are safeguarding their health and that we’re going and getting the checks that are available to us.”
According to a new study by the Hologic Global Women’s Health Index, only 15 per of women in Canada reported getting screened for breast or cervical cancer in the past year. In the U.S., 25 per cent of women report getting screened for these cancers.
Holologic, a U.S.-based medical technology company behind the index, created the index with polling firm Gallup and says it’s “one of largest collections of data on women’s health and well-being.”
The study also found that women who have lower incomes, who are a member of ethnic minority, or who are newcomers are least likely to be screened overall.
A year ago, Ontario lowered the mammogram self-referral age by 10 years. That means women in their 40s could book a mammogram without needing a doctor’s referral. With breast cancer affecting one in every nine women in Ontario, the age was lowered to enable doctors to detect the disease earlier and improve access to treatment.
“We know early detection and increased access to treatment and care saves lives,” Health Minister Sylvia Jones said last October.
But according to Ontario Health, only about 21 per cent of eligible women between the age of 40 to 49 have undergone screening since the change.
Dr. Supriya Kulkarni, a breast imaging radiologist at University Health Network’s joint department of medical imaging, said more than 1,000 mammograms were done in the last year at Women’s College Hospital.
But there are some communities that aren’t being reached, she said.
“We have immigrant populations, we have refugees, we have people with language barriers, and then we have the First Nations. There are so many different subgroups that may not be accessing our system yet, and it’s very critical that we reach out to these,” she said.
“And specifically with younger people, they tend to be more busy with young families and pressures, economic pressures and access is also an issue.”
What is a mammogram — and how much does it hurt?
Kulkarni said efforts need to be made to reach certain groups, and she hopes Ontario’s new guidelines means younger people will be screened sooner.
“It should be just a way of life that women come in for screening once in two years.”
Dr. Ritika Goel, a family doctor in Toronto, said people who are socially marginalized tend to have poorer access to health care, and that includes breast cancer screening.
“There’s lots of research that shows that racialized women or immigrant women have lower screening rates for cancer, for breast cancer, for cervical cancer,” Goel said.
“There’s also lots of data that shows that in general, people who are immigrants and racialized have poor health access, have poor health outcomes. And so this speaks more broadly to the social and structural determinants of health.”
For its part, Ontario Health said in a statement that it has created multilingual breast cancer screening materials and hosted webinars to raise awareness about the expansion.
To support underserved populations, Ontario Health said it developed preventive care programs with prevention specialists, who facilitated more than 7,000 culturally responsive breast screening conversations with racialized and underserved communities.
With the latest innovations making screening easier and more comfortable, the hope is that more women are reached, and more lives are saved.
