Ultrasound not included in regular screenings for Islanders with high breast density

·4 min read
Dense breast tissue appears white on a regular mammogram in the same way that cancer does. (Submitted by Dense Breasts Canada - image credit)
Dense breast tissue appears white on a regular mammogram in the same way that cancer does. (Submitted by Dense Breasts Canada - image credit)

Officials with Health P.E.I. say ultrasounds are not currently being used within the provincial breast screening program, and they won't be anytime soon.

In 2019, Premier Dennis King's government promised to begin notifying all Islanders who have a mammogram of their breast density. It also promised to look into the potential of adding ultrasound screening for those with the highest breast density.

Last week in the P.E.I. Legislature, a member of the Official Opposition wanted to know whether those commitments have been fulfilled.

According to Gailyne MacPherson, director of diagnostic imaging with Health P.E.I., the province has been sending letters to people notifying them of their breast density since January 2020.

She said breasts are considered dense if they have a density of more than 75 per cent and those with the densest breasts (Category D) are now called back for yearly mammograms.

"Density greater than 75 per cent is the one that some provinces recommend additional imaging and some studies recommend that people be imaged yearly by mammography," MacPherson said.

"Our province has done that for a very long time."

Jessica Doria-Brown/CBC
Jessica Doria-Brown/CBC

When it comes to expanding the breast screening program to include ultrasounds for those with high breast density, MacPherson said that's not something Health P.E.I. is doing right now.

"We started notifying people in January of 2020 and, you know, that was really the first time we had good, hard numbers on how many people that would actually be — to see what kinds of volumes we would be looking at to expand the service," she said.

As soon as that data was collected the COVID-19 pandemic hit, and any possible program expansion was put on hold as a result, she said.

MacPherson said Health P.E.I. is guided by research and evidence from experts in the field, which indicates annual mammography is an effective method of screening. She also said Health P.E.I. will consider expanding screening to include ultrasound breast screening in the future if the evidence supports its use for the dense breast population.

"If the big studies come out and say that ultrasound is indicated then we would certainly be looking at that," she said. "We will just kind of have to play it by ear and watch the evidence.

'We want to see [P.E.I.] continue to lead'

Jennie Dale, executive director of Dense Breasts Canada, said while P.E.I. is a national leader when it comes to breast screening, the program here doesn't go far enough.

"Ultrasound has significant benefits for both women in categories C and D," Dale said. "Our organization hears from women continuously about women whose cancer was missed on mammograms."

High breast density can make it more difficult to detect cancer, because the tissue looks similar to cancer on a mammogram, Dale said.

Dale said ultrasound breast screenings are currently being offered to people with high breast density in other provinces, including British Columbia and Alberta, and she'd like to see P.E.I. join them.

Submitted Jennie Dale
Submitted Jennie Dale

She said the number of people who fall into the highest category for breast density on P.E.I. would be small, making ultrasound screenings manageable.

Dale said P.E.I. has already implemented a number of practices that position it as a leader in breast screening across the country, including: making screening available to people at age 40; the ability to be screened every year, including annual mammograms for those with high breast density; as well as notifying people of their breast density.

"P.E.I. is doing great so we want to see it continue to lead — implement the screening ultrasound," Dale said.

Letters not sent to everyone

Letters notifying Islanders about their breast density will only be sent to people screened through the P.E.I Breast Screening Program.

MacPherson said people between the age of 40 and 74 can self-refer to the screening program. Anyone who has been screened through this program and has not received a letter can contact diagnostic imaging at the Queens Elizabeth Hospital or the Prince County Hospital to have one re-sent to them.

MacPherson said a letter should arrive within two to three weeks.

She said she has heard about some people not receiving their letters, which would happen if a person does not fall within that age range or if they are being screened through diagnostic imaging — that would include people who have been diagnosed with cancer previously.

In that case, breast density results will be sent to a person's physician.

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