Who is eligible for the Ontario Breast Screening Program?

The OBSP screens two groups of women, which include the following:

  • 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 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. The OBSP will not recall women over age 74 to participate in the program.  There isn’t enough high-quality scientific evidence to support screening women older than age 74 regularly. To continue screening through the OBSP, a healthcare provider will need to provide a referral.

  • 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 refused 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% confirmed through genetic assessment.
    • They received radiation therapy to the chest before 30 years of age as treatment for another cancer or condition (e.g., Hodgkin’s disease).

What is a screening mammogram?

A mammogram takes an X-ray picture of the breast and can find changes even when they are too small for you or your healthcare provider to feel or see. For most women, the mammogram results will be normal.

Mammography remains the best screening test for most women. Ontario women can receive a screening mammogram in one of two ways:

  • Through the Ontario Breast Screening Program (OBSP), a provincial screening program that provides high-quality breast cancer screening.
  • Through non-OBSP sites.

Of the 211,400 women ages 50-74 in our Region, 36.4 per cent are overdue for their mammogram or have never been screened. This means there are still many women who could benefit from regular breast cancer screening.

Why should I have a screening mammogram?

Regular breast cancer screening can find cancer when it is small, which means:

  • There’s a better chance of treating the cancer successfully.
  • It’s less likely to spread.
  • There may be more treatment options.

In Ontario, breast cancer is the most common type of cancer in women. As women get older, the chance of getting breast cancer rises. Mammograms can help to find small breast cancers before there are symptoms. If breast cancer is found at an early stage there is a high rate of successful treatment. As well, for many women, finding cancer early may allow for more treatment options, such as breast conserving surgery or less aggressive treatment.

When should I have screening mammograms?

  • In Ontario, it is recommended that women aged 50 to 74 have a screening mammogram, generally every two years.
  • Evidence shows that women aged 50−74 benefit most from regular mammograms.
  • The evidence for mammography for women aged 40−49 is not as strong as for women aged 50−74. Therefore, in Ontario it is recommended that women aged 40−49 talk to their healthcare provider to make a personal decision about mammography.
  • Women aged 30-69 who have been confirmed to be at high risk for breast cancer should have a screening mammogram and breast MRI every year.
  • The time to go for screening is when you feel fine. If you are ever worried about any breast problems, see your healthcare provider.

How effective are screening mammograms?

  • Mammograms are the best way to find breast cancer early. But, they are not perfect. They may miss some cancers. Also, some cancers develop in the interval between screens. However, many studies have shown that regular mammograms reduce the risk of dying from breast cancer.
  • Some 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.

Are mammograms safe?

Yes. Mammograms use a low dose of radiation. The benefits of screening and finding cancer early are more important than any potential harm from the X-ray.

What happens during the mammogram?

  • A registered medical radiation technologist specializing in mammography will place your breast on a special X-ray machine.
  • A plastic plate will be pressed down slowly to flatten your breast and hold it in place for a few seconds.
  • You will feel some pressure on your breast for a few seconds during the X-ray. This pressure does not harm your breast tissue.
  • Four pictures are taken, two of each breast.
  • The technologist will check the pictures to make sure they are good enough quality for the radiologist to read. If needed the technologist will take additional pictures.

How does it feel to have a mammogram?

You will feel some pressure on your breast. It feels similar to a tight blood pressure cuff. A few women experience pain but it lasts only for a few seconds. If you feel pain during the X-ray, tell the technologist. The technologist may be able to adjust the pressure. The two of you can work together to make it as comfortable an experience as possible.

Some tips…

  • Most women’s breasts are tender the week before and after their period. Book your mammogram for a time when your breasts are not so tender.
  • Some women take a mild pain relief pill, such as the kind you would take for a headache, about one hour before the appointment. Only do this if it will not affect any other medicines or any health concerns you may have.
  • Some experts suggest having less caffeine for two weeks before the appointment to help reduce tenderness.

What should I do to get ready for a mammogram?

On the day of the mammogram:

  • Do wear a two-piece outfit. You will be asked to remove your top.
  • Do not use deodorants, antiperspirants, body lotions, or talcum powders. Metals in these products can show up on the X-ray picture.

Where should I go to have a mammogram?

What does it mean if more tests are needed?

  • Most women needing more tests do not have breast cancer.
  • Your result letter will state that you need more tests.
  • Your healthcare provider or the breast screening site will book these tests for you.
  • Your OBSP screening images may need to be sent to the doctor at the centre where the tests will be done. The screening centre may be able to arrange this; however, in some cases, your help may be needed.

What advantages does the Ontario Breast Screening Program (OBSP) offer?

  • High-quality mammograms in sites accredited by the Canadian Association of Radiologists.
  • Well-developed quality assurance at each site.
  • Inviting women to participate in screening when they turn 50.
  • A reminder letter when it is time to return for next screening mammogram. Usually, this is every two years. Women over the age of 73 do not receive a reminder letter.
  • Notifying participants and primary healthcare providers of screening results.
  • Help to set up extra tests or referrals if your results suggest that they are needed.
  • Tracking participants throughout the screening process.
  • Evaluating program quality and performance.

An organized screening program can find cancer earlier, leading to better health outcomes.

How can I reduce my risk of developing 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 healthcare professional 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 ages 50 to 74 can reduce the risk of dying from breast cancer.
  • To learn your personal risk of developing certain cancers click here.

What do we know about Breast Cancer?

  • Breast cancer is the most common cancer in Canadian women, with one in nine women expected to be diagnosed in their lifetime.
  • In 2014, it is estimated that about 9,800 Ontario women will be diagnosed with breast cancer and that 1,900 will die from this disease.
  • Breast cancer occurs primarily in women 50 to 74 years of age (57% of cases)
  • Most women diagnosed with breast cancer have no family history of the disease.
  • Less than 1% of women in the general population are estimated to be at high risk for breast cancer.

There is no way to prevent breast cancer yet, but if breast cancer is found early, when it is very small, there is a good chance it can be cured.

How can I take care of my breast health?

  • Know how your breasts normally look and feel.
  • Know what breast changes to look for, such as a lump or dimpling, changes in your nipple, fluid leaking from the nipple, skin changes or redness that does not go away, or any other changes in your breasts.
  • If you notice breast changes, see your healthcare provider. Most changes are not cancerous but you should have them checked right away.
  • If you are 40–49, talk to your healthcare provider about having a mammogram.
  • If you are 50–74, go for a mammogram every two years with the Ontario Breast Screening Program.
  • If you are 30–69 and think you may be at high risk for breast cancer, talk to your healthcare provider about a referral for a yearly mammogram and breast MRI based on family or medical history.

I am Transfeminine, do I need breast screening?

  • Taking gender-affirming hormones (like estrogen) for more than five years increases your risk of developing breast cancer. If you’ve taken hormones for more than five years, and you’re between the ages of 50 and 74, you should get a mammogram (or other screening test) every two years.
  • If you’re a trans woman who has never taken gender-affirming hormones (like estrogen), or if you’ve taken hormones for fewer than five years, then you do not need to be screened regularly for breast cancer.
  • Breast implants do not increase your cancer risk. But if you’ve had implants and you have also taken gender-affirming hormones for more than five years, then you need to be screened regularly between the ages of 50 and 74. You can still have a mammogram with implants, but you’ll need a special type of mammogram, called a diagnostic mammogram. Please speak to your healthcare provider about getting a referral for a mammogram.
  • For more information about screening for trans people please visit the Canadian Cancer Society’s Get Screened webpage

I am Transmasculine, do I need chest screening?

  • If you’re a trans guy aged 50 to 74, it’s important to get screened for cancer in the chest area. This means finding cancer before there are any symptoms by getting a mammogram every two years. Even if you’ve had top surgery, you still need to monitor the health of your chest tissue.
  • For more information about screening for trans people please visit the Canadian Cancer Society’s Get Screened webpage