In February 2022, on a cold winter’s day I was walking my dog in the park, when I felt an irritation in my left breast. When I put my hand on the breast, I could feel a lump through my very puffy down filled coat.

I received my last mammogram through the Ontario Breast Screening Program in September 2019. The letter with the results stated that I did not show any signs of breast cancer but that if I wanted to continue screening I should speak to my healthcare provider and that “after the age of 74, the benefits of regular screening are not proven”. It felt to me that I was being written off because of my age. I fully intended to ask my family doctor for a mammogram referral but forgot about it. I should have had a mammogram in September 2021, 5 months before I found the lump.

I quickly made an appointment with my family doctor and she referred me for a mammogram at two places—Oakville Hospital and a private clinic-so I could get seen quickly at whichever came up first. Of course I was very worried. That weekend I started wondering if I might have an infection and went to the ER. A doctor there referred me for an ultrasound in the hospital but said it would have to be the next day, Sunday. Sunday morning, as I was getting ready to go for this appointment I received a phone call from the hospital. I was told that that was not the order of investigation and that I would have to have a mammogram before the ultrasound but that they would try to arrange it as soon as possible. A week or so later I had the mammogram, ultrasound and biopsy at the hospital. I think that perhaps, my going to the ER helped speed up the process. If I had been seen first at the private clinic, there would have been some delay as I would have needed a further appointment at the hospital for the biopsy.

I met with a very kind surgeon by the end of February and he confirmed what I expected—that I did have breast cancer. Unfortunately, because of the size of the tumour, my breast could not be saved and I needed a mastectomy. My surgeon offered me the alternatives of a double mastectomy and breast reconstruction as well as the single breast mastectomy. I initially rejected reconstruction because of the experience of two women I knew, one who died of breast cancer after reconstruction and one who had a painful experience with later reconstruction. However, after visiting a store which sold prostheses, I started to feel really down thinking about being lopsided and having to put on prosthetic breast every day. My surgeon encouraged me to further investigate reconstruction. I spoke with a plastic surgeon who had a special interest in breast reconstruction. I decided to go ahead with the team surgery—two surgeons, mastectomy, removal of 5 connected lymph nodes and reconstruction. It was successful and I am happy that I made that decision.
My surgeon informed me that since lymph node sampling showed no evidence that the cancer had spread and the margins of the tumour were clear, I would not require radiation or chemotherapy.

However, when I met with my oncologist a few weeks later, I was shocked when one of his first questions was whether I would consider chemotherapy. He recommended Oncotype testing to determine how aggressive the tumour was and whether I would ‘benefit’ from chemotherapy. He said that he would not recommend the Oncotype testing if I would not consider chemotherapy. It turned out that the tumour was very aggressive and preventive chemo was recommended. I had four chemo sessions in the summer of 2022. I currently take an estrogen blocking medication daily and have a bone density infusion, which has some breast cancer preventing properties, twice a year. I am seen at the cancer clinic every 6 months and have a mammogram once a year.

I consider myself fortunate that I found the tumour when I did and it seems not to have spread. I have been happy with the care from my surgeons, the timeliness of the mammogram and biopsy after I found the tumour and the timeliness of the surgery.
However, I can’t help but wonder what would have happened had I had the screening mammogram 5 months earlier. Perhaps my breast could have been saved and perhaps I would be at less risk for recurrence.

I strongly feel that regular screening should happen for women over the age of 74. We older women get breast cancer. I know several women in their 70s and 80s who have had it.

What does the Ontario Breast Screening Program mean when they say “the benefits are not proven”? Nobody chooses to die from an advanced breast cancer that could have been identified earlier and treated. Do they mean we older women are not worth the money spent on screening because of limited number of years ahead in our life span?

DBC NOTE: Mary, we are so grateful that you have shared your story. We feel it is discriminatory for women in 6 provinces to still need a requisition to screen after age 74. Ontario is one. The screening program is being sly and unethical when they say the benefits are not proven- it is because all the studies that were done decades ago only included women up to age 74. Women are now living longer and we now know the benefits of screening past 74. We need to use our collective voices to ensure all women in Canada over 74 can self-refer, no matter where they live.