What to do for Breast Cancer Awareness Month
Every October, out come the pink ribbons as marches and fundraisers are organized to help fight women’s cancers. In Eeyou Istchee, breast -ancer screenings for women between the ages of 50-69 are handled in a unique way – every two years a screening team visits all nine communities in an initiative coordinated by the Cree Health Board and Social Services of James Bay (CBHSSJB).
In Eeyou Istchee, these screenings are handled by a special team, that includes Irene Chu (a nurse counsellor for Chronic Diseases Management), Lucy Trapper (a program planning research officer for Chronic Diseases Management) and Maggie Odell (medical advisor for Public Health).
According to Irene Chu, the Institute of Public Health of Quebec developed the Clara Bus, a mammogram machine transported by bus, and Sophie Air, a plane that brings a mammogram machine to remote clinics, so that Cree don’t have to leave the territory for a screening every two years.
“Those who miss the being screened with the Clara Bus and Sophie Air are encouraged to visit their local CMC and to arrange a screening at the Chibougamau Hospital or Val-d’Or Hospital,” said Chu.
The Chishaayiyuu Department oversees the whole prprogramocess and works closely with the radiology department and the local CMC and CHB’s Wiichihiituwin Department for transport arrangements.
The rate of breast cancer among Crees is no higher than that of the general population. The screening rate hovers around 70%, which is about what the CHBSSJB aims for. Chu pointed out that one of the problems they face with the Clara Bus is that it only stays in a community for two days every two years. Women who are unavailable or out of town at the time have to travel to hospitals either in Val-d’Or or Chibougamau.
There are other issues with the screening process, Chu said.
“The reality is that there is a high false positive rate,” she noted. “Some women could have an abnormal result from having a mammogram screening and could be asked to undergo additional investigative examinations by the radiologist. Often it is not breast cancer. This can cause over-testing and high anxiety levels.”
There is also a risk of over-diagnosis, which is when a woman receives a diagnosis for cancer that might never have had an effect on her health, like a cancer that develops very slowly or is a benign lump.
For those who have a history of female cancers in their families, who have relatives have died of breast, ovarian or cervical cancer, genetic testing for BCRA-1 and BCRA-2 is available but is reserved for extreme cases.
“We do not routinely recommend genetic testing for all women. We encourage women who have a sister, mother or aunt with cancer to visit their physician to discuss if genetic testing would be advised,” explained Chu.
“The answer will generally depend on the age of diagnosis, and how many family members were affected.”
Chu added that if cancer has been quite frequent among a patient’s female family members, testing would be warranted and would be followed up at the McGill University Health Centre.