The first day of October means breast cancer awareness month has begun. It’s the most frequently diagnosed cancer among Canadian women — but it has a very high survival rate, if it’s detected early.
Everyone knows someone who has been touched by breast cancer. But still only about 60 per cent of eligible women receive routine mammograms. Most doctors agree that they aren’t perfect, but right now, they’re the best screening method we have to detect breast cancer early.
Margaret Cheverie has been breast cancer free for eleven years, and she credits early detection: “You couldn’t feel the lump there. There was no indication there was anything there until I had the mammogram.”
Her stage one tumour was discovered at a routine mammogram.
A mammogram isn’t foolproof but it’s much better at detecting than the human touch. With a regular mammogram, you can find something as small as a grain of rice, with a self exam, it could be larger than a grape by the time you detect it.
Dr. Meghan Davis, Regional Cancer Care Lead, Juravinski Cancer Centre: “It’s not perfect. It can miss things. It can find things that aren’t there. But it is the only thing we do have for screening.”
Women between 50 and 74 should get one every two years. Women at high risk because of genetic factors may need one earlier or more frequently.
Some research suggests they’re ineffective. They can detect tumours that may never grow to a problematic size, leading to unnecessary surgery. But doctors believe it’s better to find all than none.
Dr. Davis: “We find the slow growing ones too. But we have to find all of them to find the ones that save lives.”
Soon, high risk patients may have an alternative to a mammogram or standard MRI. The ‘IGAR Breast’ is a robotic device developed using Canadarm technology. It’s set to begin phase two testing at St. Joseph’s Healthcare in Hamilton.
Dr. Mehran Anvari, Professor of Surgery, McMaster University: “With this technology, if the MRI detects even the smallest lesion, the robot can actually go in and biopsy and we hope in future also potentially ablate the lesion.”
Ideally, a mass could be detected, biopsied, and removed all in one visit. If a biopsy shows a tumour is very slow growing, surgery can be avoided.
IGAR is only about a year and a half away from being widely accessible, but it still won’t be the first line of defence for most women. Step one is still the mammogram.
Right now, high risk patients have MRI screenings, and IGAR — Image Guided Automated Robot– could make those more accurate. Breasts move around, and it can be hard to pinpoint a mass during a separate biopsy. But when the biopsy is done while the patient is still in the machine, you can target it much more directly.
For patients who aren’t high risk, the mammogram is still the way to go. Self breast exams are a thing of the past. This website will provide information on how to book a mammogram.”