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Ontario Breast Screening Program (OBSP) - Frequently Asked Questions 1) When should women get screened for breast cancer? The Ontario Breast Screening Program (OBSP) recommends that women aged 50 to 74 years who are at average risk for breast cancer have a screening mammogram every two years. Women aged 30 to 69 years who have been identified as being at high risk for breast cancer should have a screening mammogram and breast magnetic resonance imaging (MRI) every year. To learn more about the OBSP, visit http://www.cancercare.on.ca/pcs/screening/breastscreening/OBSP. 2) Who is eligible for screening through the OBSP? The OBSP screens two groups of women: a) Ontario residents at average risk for breast cancer who are 50 to 74* years of age and have: no acute breast symptoms no personal history of breast cancer no current breast implants not had a screening mammogram within the last 11 months *Women over age 74 can be screened within the OBSP; however, they are encouraged to make a personal decision about breast cancer screening in consultation with their healthcare provider, and will need a referral from their healthcare provider in order to obtain a mammogram. The OBSP will not recall women over age 74 to participate in the program. There is no high-quality scientific evidence to support screening mammography in women over 74 years of age. b) Ontario residents at high risk for breast cancer aged 30 to 69 years who have a referral from their physician, have no acute breast symptoms and fall into one of the following risk categories: They have a genetic mutation that puts them at high risk for breast cancer. They have declined genetic testing, and have a parent, sibling or child with a genetic mutation that puts them at high risk for breast cancer. They have a family history that indicates a lifetime risk of breast cancer that is greater or equal to 25 percent confirmed through genetic assessment. They received radiation therapy to the chest as a treatment for another cancer or condition (e.g., Hodgkin lymphoma) before 30 years of age and at least eight years ago. 3) How can women arrange for screening through the OBSP? Women aged 50 to 74 years can book their own appointments or be referred by a family doctor or nurse practitioner. Women aged 30 to 69 years who think they may be at high risk for breast cancer need a referral from a physician, based on their family or medical history. Women who have already been screened at an OBSP site are reminded by letter when they are due for their next screening appointment until they turn 74 years of age. No additional referral is needed. Women over 74 years of age may undergo mammography screening in the OBSP, however they require a referral from their healthcare provider. Women can find the nearest OBSP site by calling 1-800-668-9304 or visiting http://www.cancercare.on.ca/pcs/screening/breastscreening/locations. 4) What is a mammogram? A mammogram is a special X-ray machine that takes a picture of the breast and detects any changes that have occurred, even those too small for the average person to feel or see. A mammogram is administered by a registered medical radiation technologist, and involves a plastic plate that is slowly pressed down to flatten the breast and hold it in place for a few seconds. The patient will feel some pressure on the breast for a few seconds, but this pressure will not harm breast tissue. 5) Should women in their 40s who are at average risk for breast cancer be screened? The OBSP does not screen women aged 40 to 49 years at average risk for breast cancer with mammography. A greater reduction in risk of death from breast cancer is seen with mammography for screening women at average risk aged 50 to 74 years than among similar women aged 40 to 49 years. Women in their 40s are encouraged to make a personal decision about breast cancer screening in consultation with their family doctor or nurse practitioner. 6) At what age should breast cancer screening be stopped? The OBSP recommends that women at average risk for breast cancer aged 50 to 74 years be screened every two years for breast cancer. Women over age 74 are encouraged to make a personal decision about breast cancer screening in consultation with their family doctor or nurse practitioner. The OBSP recommends that women aged 30 to 69 years identified as being at high risk for breast cancer get screened every year for breast cancer with mammography and breast magnetic resonance imaging (MRI). Between the ages of 70 and 74 years, the OBSP recommends that women at high risk for breast cancer be screened with mammography only each year. Women over age 74 are encouraged to make a personal decision about breast cancer screening in consultation with their family doctor or nurse practitioner. 7) How many women at average risk get screened through the Ontario Breast Screening Program (OBSP)? In 2012–2013, approximately 1.15 million Ontario women aged 50 to 74 years old were screened for breast cancer with a mammogram. This represents a participation rate of 59 per cent among the 1.95 million women who were eligible for screening. Of the women who were screened, the proportion participating through the OBSP has increased from 58 per cent in 2006–2007 to 76 per cent (873,761) in 2012–2013. In 2014, 581,196 mammograms were performed on OBSP average risk women. Women are encouraged to get screened through the OBSP because as an organized screening program it offers important benefits, such as: inviting women to participate in screening reminding participants when it is time for their next screening test notifying participants of screening results tracking participants throughout screening processes evaluating program quality and performance 8) How can I reduce my risk of breast cancer? A healthy lifestyle can reduce the risk of breast cancer. Women should: avoid alcohol or have no more than one alcoholic drink per day limit their time on hormone replacement therapy, if used, and talk with their family doctor or nurse practitioner before making any medication changes maintain a healthy body weight, especially after menopause be physically active as part of everyday life get screened—regular mammograms, generally every two years, are the best way most women aged 50 to 74 years can protect themselves from dying of breast cancer 9) Are there any harms associated with breast cancer screening? Mammograms may miss some breast cancers and some cancers develop in the time between screens. These are among the reasons that regular screening is important. Mammography may produce abnormal results, raising the suspicion of cancer, when, in fact, additional imaging or biopsies show there is no cancer. Some breast cancers that appear on a mammogram may never progress to the point where a woman has symptoms during her lifetime. Therefore, some women may have surgery or treatment for a breast cancer that would never have been life-threatening. Not all cancers found at screening can be cured.