CAR

Canadian Association of Radiologist’s accreditated for Mammography

OBSP

Ontario Breast Screening Program

Mammogram Clinic in Toronto

Visit our Downtown Toronto Mammogram Clinic – Specializing in Mammography

Screening is key to the early detection of breast cancer. Annual screening mammography is currently recommended by most National organizations for all women over the age of 40. It can detect a cancer in the breast up to two years before a patient or physician can feel the lump. The Toronto Centre for Medical Imaging is also a screening centre for the Ontario Breast Screening Program and has been accredited by the Canadian Association of Radiologists since 1998.

Following screening mammography, about 10% of women will be recalled for additional views. This should not cause undue worry as more than 9 out of 10 patients that get recalled for additional views are subsequently categorized as “benign” or “probably benign”.

If we feel that additional views are necessary, one of our staff will contact you and schedule an appointment on behalf of your physician. If we feel a biopsy is required, we will schedule an appointment within a week to have this procedure completed, pending authorization from you and your physician.

Mammography Clinics Downtown Toronto

Supplementary Screening for Dense Breasts (ABUS)

If you have been told that you have dense breasts supplemental screening with automated breast ultrasound may be beneficial for you as part of your regular screening for breast cancer.

It is important for you to understand the following about breast density (BI-RADS category C and D) which you may have been told you have or seen on your report.

  1. Greater breast density results in lower sensitivity for mammography and higher likelihood that cancer will be missed.
  2. The assessment of breast density is subjective and, therefore, variable.
  3. Density itself is a risk factor. Women with dense breasts have approximately 1.5 to 3 times higher risk than the average woman, or woman with fatty breasts.
  4. Breast density can be affected by age and weight and therefore can change over time.
  5. Routine screening mammogram is recommended for women over age 40. ABUS (automated breast ultrasound) is not a substitute for your mammogram. ABUS is supplementary to your mammogram.

*Note that supplementary screening for dense breast (ABUS) is currently not approved by OHIP. There will be a charge for this service.

Insurance companies are slowly recognizing the utility of this service, and some are covering it under their benefits plans.

Introduction

  • If you are considering ABUS, you are concerned about breast cancer and are aware of the importance of early detection.
  • If you are considering screening for breast cancer with ABUS, please review the following

You will find here, FACTS on the current thinking among breast imaging experts on screening for breast cancer.

Risk for breast cancer is divided into 3 broad categories:

  • Average Risk: Women with 10-15% lifetime risk of cancer.
    • Most women fall in this category if:
      • There is no personal or first degree relative with a history of breast cancer and,
      • Not dense breasts on mammography.
  • Intermediate Risk: Women with 15-20% lifetime risk of cancer.
    • This is the next big category if:
      • Personal history of breast cancer after age 50.
      • First degree relative with a history of breast cancer.
      • Dense breasts on mammography.
  • High Risk: Women with greater than 20% lifetime risk of cancer.
    • This is the category that requires the closest monitoring:
      • Personal history of breast cancer before age 50, or
      • There is BRCA genetic mutation, or
      • History of radiation treatment to the chest between age 10 to 30.

Generally Accepted Guidelines For Breast Cancer Screening (including Canadian Association of Radiologists, Society of Breast Imaging, American College of Radiology, American Cancer Society)

Women at Average Risk

  • Annual screening mammogram beginning at age 40 (since women in this category, by definition, have non-dense breasts, no supplementary imaging is warranted. Regular hand held ultrasound or private pay ABUS does not increase cancer detection).
  • Periodic breast self examination

Women at Intermediate Risk

  • Annual screening mammogram beginning at age 40.
  • For women in this category with non-dense breasts, addition of digital breast tomosynthesis (DBT), not widely available in Ontario would be of benefit. Regular hand held ultrasound or private pay ABUS does not increase cancer detection.
  • For women in this category with Category C dense breasts, addition of digital breast tomosynthesis (DBT or 3D mammography), not widely available in Ontario would be of benefit. DBT is minimally helpful in Category D dense breasts. Supplementary screening with private pay ABUS increases cancer detection by up to 50%, is therefore beneficial and recommended.

Women at High Risk

  • Annual MRI starting at age 25.
  • Annual mammography, preferably with DBT, starting at age 30.

In Summary,

  1. Mammography is the backbone of any screening program for breast cancer.
  2. Supplemental screening with ABUS is only beneficial in women with dense breasts (Type C or D) and should only be done in conjunction with screening mammography.
  3. Screening with MRI is reserved for the small, but significant, percentage of women at high risk for developing breast cancer.

The best time to book your mammogram procedure is one week following your period to reduce breast sensitivity. On the day of the study, wear comfortable clothing and do not wear deodorant, talcum powder, or lotion under your arms, on the day of your test, as these can affect the quality of the image.

Mammography Screening Information – Video

Breast Density Screening with ABUS

Dr. Stacey Kean – Mammography Saves Lives