Breast Cancer Screening
Frequently Asked Questions On Breast Cancer Screening And Screening Methods
Frequently Asked Questions On The Ontario Breast Screening Program (OBSP)
What is a mammogram?
A mammogram is a low dose X-ray of the breast used to detect abnormalities, even when they may be too small for you or your doctor or nurse practitioner to feel or see.
Regular mammograms are the most effective way to find early signs of breast cancer for most women.
What happens during a mammogram?
- A technologist specializing in mammographywill place your breast on a special X-ray machine.
- A plastic plate will be pressed down slowly to flatten your breast and hold it in place for a few seconds.
- You will feel some pressure on your breast for a few seconds during the X-ray. This pressure does not harm your breast tissue.
- Pictures are taken, two of each breast.
- The technologist will check the pictures to make sure they are good enough quality to read. If not, the technologist will take more pictures. Movement, breast positioning, or denseness of the breast can affect the quality of the pictures.
- For most women, it takes less than 10 minutes to get a mammogram.
How does a mammogram feel?
You will feel some pressure on your breast. It feels a bit like a tight blood pressure cuff. A few women feel pain but it lasts only for a few seconds. If you feel pain during the X-ray, tell the technologist. The technologist may be able to adjust the pressure. The two of you can work together to help you feel as comfortable as possible.
Is there anything I can do to make the test easier?
- Most women's breasts are tender the week before and after their period. Book your mammogram for a time when your breasts are not so tender.
- Some women take a mild pain relief pill, like the kind you would take for a headache, about one hour before the appointment. Only do this if it will not affect any other medicines or any health concerns you may have.
- Some experts say that having less caffeine (like coffee, tea or other drinks high in caffeine) for two weeks before your mammogram can help reduce tenderness.
- On the day of the mammogram :
- Wear a two-piece outfit. You will be asked to remove your top.
- Do not use deodorants, antiperspirants, body lotions or talcum powders. Metals in these products can show up on the X-ray picture.
How effective are screening mammograms?
- Mammograms are the best way to find breast cancer early in women with an average risk of breast cancer. But they are not perfect. They may miss some cancers. As well, some cancers show up in the intervals between screenings. However, many studies show that regular mammograms are the most effective way to detect breast cancer early.
- Not all cancers found at screening can be cured. However, when breast cancer is caught early, 95% of women are alive and healthy five years following treatment.
- For more information, please read the Ontario Breast Screening Program 20th Anniversary Report.
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What is Magnetic Resonance Imaging?
Magnetic Resonance Imaging (MRI) is a simple test that takes a very detailed picture of your breast and can help doctors and nurse practitioners find signs of breast cancer in women at high risk.
An MRI takes multiple images of your breast to detect cancer and other abnormalities. The MRI uses a powerful magnetic field, radio pulses and a computer to make the picture. An MRI test does not use radiation (x-rays). The picture can then be examined on a computer, sent electronically and printed.
An MRI can take between 30 and 45 minutes for most women depending on the number of views that are taken during the test.
Who can I call if I have questions about the tests?
If you have any questions that are not answered here you can email us or phone INFOline at 1-866-410-5853, or speak to your doctor or nurse practitioner.
How many women in Ontario are at high risk of developing breast cancer?
It is estimated that approximately 34,000 women (between the ages of 30 to 69 years) in Ontario are at high risk and would be eligible for annual mammogram and MRI screening.
High risk is confirmed through genetic testing and assessment using tools or questionnaires that identify a woman's lifetime risk. These tools also identify which women are most likely to have certain genetic mutations. Confirmation of the genetic mutation is done using a blood sample, usually following assessment at one of the province's genetic centres. Find out what to ask your doctor about genetic assessment.
Should all women be receiving an MRI for breast cancer screening?
No. A mammogram is the most effective tool for the early detection of breast cancer for most women. Breast MRI in addition to a mammogram has been shown to be an effective tool for high-risk women, such as women with a BRCA1 or BRCA2 gene.
Why do women with a high risk of developing breast cancer need a mammogram and an MRI annually?
There are benefits and limitations to all diagnostic tests. The benefit of an MRI is that it has increased sensitivity for women with a genetic predisposition to breast cancer due to the faster growth of breast cancers in these populations. It has also been suggested that breast cancers in women at high risk may exhibit features that appear benign on a mammogram.
Unlike a mammogram, an MRI is not influenced by breast density, which is more common in younger women. MRI also does not have the same radiologic risk for women, which means reduced exposure to radiation when receiving annual testing for up to 40 years.
Used in combination, mammograms and MRI find more cancers than using MRI alone.
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FAQ On The Ontario Breast Screening Program (OBSP)
What is the OBSP?
The OBSP is a Cancer Care Ontario initiative that provides organized breast screening services to women. The Ministry of Health and Long-Term Care funds breast screening services for women.
What services does the OBSP provide?
The OBSP provides high-quality mammograms in Canadian Association of Radiologists accredited sites. The OBSP will provide your family doctor or nurse practitioner results within two weeks of your appointment. The OBSP will also help set up extra tests or referrals if your results suggest that they are needed, and a reminder letter when it is time to return for your next screening mammogram.
Do I need a doctor's referral to participate in the OBSP?
Women aged 50 and over may refer themselves to the OBSP. To self-refer, please call an OBSP site directly to make an appointment. To find an OBSP site close to you, you can search for one in your area at Health Care Options Directory. To find out more about when you should screen for breast cancer, take two minutes to answer the Time To Screen Tool questions.
If you are between the age 30 to 69 and your family history or genetics suggest that you may be at high risk for breast cancer, you will need a referral from your doctor or nurse practitioner to the OBSP.
How do I find out my results?
If you are part of the OBSP, you will get a letter from the program. If your result is inconclusive and further testing is required, you will receive a phone call.
If you are not part of the OBSP, your family doctor or nurse practitioner will receive your results and will contact you.
What will happen if my test comes back negative?
If you are part of the OBSP, you will be notified when it's time for your next mammogram.
What if I don't have a doctor or nurse practitioner?
You can go to Health Care Connect to find one, or talk to a registered nurse at Telehealth.
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I'm 50 or over. I'd like to participate in the OBSP. How do I make an appointment?
Please call an OBSP site directly to make an appointment.
To find an OBSP location near you, go to the Health Care Options Directory for an easy-to-use search tool. A mobile coach provides service to more than 30 communities in Northwestern Ontario.
Who is eligible to participate in the OBSP?
Women eligible to participate in the OBSP are Ontario residents, 50 years of age or older, who have no acute breast symptoms or problems, no current breast implants, have no personal history of breast cancer and have not had a mammogram within the past 11 months.
I'm in my 40's and have no history of breast cancer. Should I go for a mammogram?
The evidence for screening mammograms for women aged 40-49 is not as strong as for women age 50-74. Women aged 50 and older are at greater risk for developing breast cancer than younger women. Therefore, in Ontario it is recommended that women aged 40-49 talk to their family doctor or nurse practitioner about the benefits and risks of mammogram screening.
Where should I go for a mammogram if there is no OBSP site close to me?
If there is no OBSP site close to you, you can still be screened for breast cancer.To find a breast screening centre near you, go to the Health Care Options Directory for an easy-to-use search tool. You must have a referral from a doctor or nurse practitioner to be screened for breast cancer outside the Ontario Breast Screening Program.
Or call the Canadian Cancer Society Cancer Information Service at 1-888-939-3333.
I'm under 50. Where do I go for a mammogram?
In Ontario, women under the age of 50 need a family doctor or nurse practitioner referral for a mammogram. A screening mammogram is generally not recommended for women under 50 unless they are identified as high risk. Only 2 out of 10 women who develop breast cancer are under the age of 50.
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I'm over 74. Can I participate in the OBSP?
Women over the age of 74 can participate in the OBSP. However, we encourage these women to consult their family doctor or nurse practitioner.
I found a lump in my breast. Can I come to the OBSP?
The Ontario Breast Screening Program (OBSP) is a mammogram screening program for women who do not have breast problems or symptoms. Women experiencing breast problems/symptoms need to see a family doctor or nurse practitioner for assessment and referrals for any follow-up testing required.
I have implants. Can I participate in the OBSP? Can I have mammograms?
Women with current breast implants are not eligible for the OBSP. Diagnostic mammogram equipment, rather than a screening mammogram, is required for screening women with implants. Therefore, women need a referral from their family doctor or nurse practitioner to an appropriate centre.
Are there other tests equally effective as mammograms?
There is strong evidence that a mammogram is the best way to find breast cancer early in women aged 50 and older.
For women who are at high risk of developing breast cancer (e.g., BRCA1 and BRCA2 gene mutation carriers), annual mammogram combined with breast Magnetic Resonance Imaging (MRI) is recommended beginning at age 30.
I'm not eligible for breast screening through the OBSP and do not have a family physician or nurse practitioner for a referral. What should I do?
If you don't have a family doctor or nurse practitioner and would like help finding one, you can sign up by visiting Health Care Connect or calling 1-800-445-1822.
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Where can I get more information on the privacy statement for the Ontario Breast Screening Program?
A copy of the privacy statement is available on this site. If you have further questions, you can phone the Ontario Breast Screening Program at 1-800-668-9304
How does the Ontario Breast Screening Program use my personal health information?
The OBSP compiles personal health information in order to:
- Notify participants of their screening results
- Remind participants about future screenings
- Ensure the OBSP is meeting its objectives to help women get the right breast screening for them, when they need it
How can I withdraw from the OBSP?
At any time, you may ask the OBSP not to contact you. If you choose to do this, you will still be able to do be screened for breast cancer if your doctor or nurse practitioner refers you if you wish. After that the OBSP will not invite you to do breast cancer screening or remind you to be screened again.
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