High-risk mammogram patients 'hesitant' to show up for appointments amid COVID-19

Staff at the Nova Scotia breast screening program are trying to reassure patients that it's safe to come in after an alarming number of high-risk women skipped their mammogram.

"It's a little disheartening. If people aren't comfortable coming, they really shouldn't take an appointment," said Trena Metcalfe, the program manager for the Nova Scotia breast screening program.

High-risk patients include breast cancer survivors, and women showing symptoms such as a lump.

While emergency mammograms continued at hospitals amid COVID-19, screenings at clinics were shut down for two months. This meant that 12,000 routine appointments and 6,000 diagnostic appointments for higher-risk patients were missed out on.

Mammograms started up again for high-risk patients on May 13. But right away, Metcalfe knew there was an issue.

Typically, women miss just five per cent of their appointments. Last week, twice as many didn't show up at the Halifax clinic, despite booking the appointment just 48 hours in advance.

Brian MacKay/CBC

"Sometimes it takes an hour [of phone calls] just to get four appointment times filled because people aren't comfortable," she said.

Those who miss an appointment are given another one next year.

The staff at the clinic say they appreciate that the pandemic is stressful, especially for those who fall in a high-risk category. They say they've spent quite a bit of time ensuring steps are taken to protect both patients and employees.

"People are a little bit hesitant," said Denise Wright, the supervisor for the Dartmouth, Halifax and Cobequid clinics.

"It's a very safe environment here. But if you aren't comfortable, we will book you further down the road."

The clinic at the Halifax Shopping Centre is the largest in the province. Right now, just three patients are coming in at a time to make sure the waiting room stays clear. Smaller clinics are booking one patient every half-hour.

Extra precautions being taken

Patients are screened repeatedly before they come into the building.

"We worked with infection control staff from the IWK to make sure that we have safe practices, safe guidelines," Wright said.

Patients are also asked to sanitize their hands as they come into the screening room.

Wright acknowledges that a mammogram is an intimate experience, but said all technicians are wearing masks and disinfecting surfaces.

"We're less than a foot away from each other, if not inches, so I understand that people would be hesitant," she said.

Brian MacKay/CBC

The missed appointments are frustrating for the staff who are trying to play catch up.

Even before the shutdown, the average wait for a mammogram in Nova Scotia was 97 days. The average wait for a diagnostic mammogram — cases when a woman is symptomatic — was about 40 days.

Metcalfe said they don't know how long it will take to deal with the backlog.

"We're working at a much lower capacity now with the physical distancing and the time requirements, so it's going to take quite a bit of time," she said.

Metcalfe said they're making a number of changes to try to speed things up, including working overtime and changing schedules.

They're also making use of the mobile clinic. It's supposed to be used as a service for asymptomatic women in rural communities, but this year's schedule is being tossed out. Metcalfe said it, too, will focus on priority cases for now.

1 in 8 N.S. women will get breast cancer

She said she doesn't know when they'll start accepting new bookings, as they're doing their best to see all high-risk patients as soon as possible.

Metcalfe is hopeful that as the province continues to open up, more patients will be ready to get their mammogram.

The clinic estimates one in eight Nova Scotia women will get breast cancer.

"It is very important for people to have their screening tests done," she said.

"The most important thing is that you continue to come because that's where you see the biggest benefit, is when you're routinely having them done and they can compare to your previous exam and find things sooner."