BC updates breast cancer screening policy

VANCOUVER, B.C. – The BC Cancer Agency is announcing BC’s revised breast cancer screening policy, emphasizing informed choice for women.

The announcement coincides with World Cancer Day, Feb 4, 2014.

As part of the Provincial Breast Health Strategy, the new policy was developed after a comprehensive review of scientific data and other evidence-based screening mammography materials. The changes to BC's screening policy, effective today, provide clarity to women on when to get screened and will help women to make informed decisions about screening.

The updated policy includes a new recommendation for women 40-74 years old with a family history of breast cancer in a first degree relative (mother, sister or daughter) to receive annual screening. Women in this category are nearly two times more likely to develop breast cancer and offering them annual screening is a step towards tailoring a screening schedule on the basis of personal risk.

Women ages 40 to 49 will continue to have access to screening every two years without a doctor’s referral, however, they are encouraged to make an informed choice by speaking to their primary health care provider to discuss the benefits and limitations of screening. The change in policy from annual screening to screening every two years is in keeping with evidence from randomized clinical trials that shows relatively low levels of cancer incidence in this age group compared to older age groups. Some limitations of mammography for this group include the decreased sensitivity of mammography as they tend to have denser breast tissue, which can lead to a higher rate of false positive results.

The policy recommendation remains unchanged for women ages 50 to 74. Women in this age group should be screened every two years, as this age group stands to benefit the most from routine screening. Over 80 per cent of new breast cancers diagnosed each year are in women aged 50 or older. Screening in this age group is so important that starting in mid-February an education campaign will be launched reminding women of the importance of regular mammograms.

recall patients.

• Women age 75 and older: Continue to have access to breast screening without a doctor’s referral, however, they are encouraged to make an informed choice by speaking to their primary health care provider about the benefits and limitations of screening in the context of their personal health.
• Women age 40 and younger: A doctor’s referral will be needed for women in this age group who have a personal high risk of developing breast cancer, provided they do not have breast implants or an indication for a diagnostic mammogram.
• Self Breast Exam: Routine self-breast examinations as the only method to screen for breast cancer are not recommended for women at average risk of developing breast cancer.
• Clinical Breast Exam: There is insufficient evidence to either support or refute routine clinical breast exams in the absence of symptoms alone or in conjunction with mammography.
• Magnetic Resonance Imaging (MRI): Routine screening with breast MRI of women at average risk of developing breast cancer is not recommended.

• All women should be familiar with their breast texture and appearance and bring any concerns to their doctor.

Quotes

“As part of the Provincial Breast Health Strategy, BC’s updated screening policy reflects our commitment to reducing breast cancer deaths by finding cancer at an early stage province-wide. Early detection of breast cancer remains the best defence. The evidence is clear – women aged 50 to 74 should be screened every two years as they benefit the most from routine screening.“

"I am very grateful for the many experts that have contributed to updating BC's breast cancer screening guidelines. At present, based on available high level evidence a ‘one-size-fits-all’ approach to breast cancer screening does not seem to make sense for women aged 40 to 49 years, or those over 75. Therefore, the updated policy encourages women in these age groups to make an informed decision whether or not to be screened by speaking with their primary care provider about their personal risk, to ensure they are aware of the benefits and limitations of screening mammography. The BC Cancer Agency remains committed to reviewing data and research about screening in these age groups and have these inform our screening guidelines. For those aged 50 to 74 meanwhile, evidence clearly supports screening every two years and we want as many women as possible in this age group take advantage of the benefits of regular screening."

“Through our province-wide community of donors, the BC Cancer Foundation is pleased to continue supporting breast cancer screening community outreach projects and research at the BC Cancer Agency. This updated screening mammography policy is a great example of how research through the Agency is helping to expand our understanding of cancer, using the latest evidence to dramatically improve cancer detection and treatment in BC.”

“We are very pleased that BC’s updated Breast Screening Policy clarifies at what age and how often women should have a mammogram, since we know that mammograms save lives. We look forward to partnering with the BC Cancer Agency on the launch of a joint public campaign to help raise awareness of the importance of screening mammograms later this month.“

“We know early detection has an important role to play in the fight against cancer and that screening mammography is most effective for women between 50 and 69. We’re pleased the government, the BC Cancer Agency and supporting partners are launching an education campaign to encourage women in this age bracket to get regular mammograms and to assist all women in making informed decisions about mammography.”

• Breast cancer is the most common type of cancer diagnosed in Canadian women.
• BC has one of the lowest incidence rates and has the second lowest mortality rate of breast cancer in the country for those women who do get breast cancer.
• In 2014, an estimated 3,600 women will be diagnosed with breast cancer in British Columbia, and approximately 570 will die from the disease.
• Over 80 per cent of new breast cancers diagnosed each year in BC are in women age 50 or over.
• Mammograms help find cancer in its earliest stages – when there are more treatment options and a better chance for successful treatment.
• In 2012, 281,715 screening mammograms were performed in BC, and 1,264 breast cancers were reported (4.5 per 1,000 exams).

• Research has shown a 25 per cent reduction in deaths from breast cancer among women who are screened through the Screening Mammography Program of BC.

For more information on BC’s updated Breast Screening Policy and the Screening Mammography Program, please visit www.screeningbc.ca/breast.

The BC Cancer Agency, an agency of the Provincial Health Services Authority, is committed to reducing the incidence of cancer, reducing the mortality from cancer, and improving the quality of life of those living with cancer. It provides a comprehensive cancer control program for the people of British Columbia by working with community partners to deliver a range of oncology services, including prevention, early detection, diagnosis and treatment, research, education, supportive care, rehabilitation and palliative care. For more information, visit www.bccancer.bc.ca.

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