More women in their 40s are coming to Lake of the Woods District Hospital for breast screening, and some are being diagnosed with early-stage cancer on their first mammogram, says Dr. Catherine Murray.
The radiologist and diagnostic imaging service lead said the increase follows Ontario’s October 2024 decision to lower the starting age for its breast screening program from 50 to 40.
The change opened self-referral screening to an age group previously excluded from the program, Murray said.
“And we are picking up a lot of cancers in those early stages, even on first mammograms, which has been huge and makes you feel like this is all sort of worthwhile,” she told the Miner and News.
Finding cancer early generally makes it easier to treat, she said. But a clear mammogram does not rule out a cancer developing before the next appointment, or an abnormality that was difficult to see on an earlier image.
A new lump, skin change or nipple change warrants a conversation with a doctor or nurse practitioner, even after a normal result. Murray said those patients would undergo a diagnostic assessment, potentially involving a mammogram, ultrasound or both.
How clearly an abnormality appears can depend partly on breast density. Dense tissue makes small masses harder to distinguish on a mammogram, she explained.
“So when you get your report back from your screener, check and see what your density is.”
The hospital’s mammography equipment has also changed. Its replacement unit, installed in November 2024 and supported through the Lake of the Woods District Hospital Foundation’s Beyond the Scan campaign, offers 3D imaging, contrast-enhanced mammography, mammogram-guided biopsies and AI-assisted image review.
The previous machine produced only conventional two-dimensional images, Murray said. With 3D imaging, radiologists can examine tissue layers to get a clearer view of a possible abnormality.
Sometimes, what appears suspicious on a two-dimensional image turns out to be breast tissue overlapping itself.
The team can also use intravenous contrast dye to identify areas needing closer examination and biopsy abnormalities visible on mammograms.
Earlier images remain useful, even with the upgraded technology. Murray said comparing mammograms over time helps radiologists identify subtle changes and recognize findings that have remained stable for years.
That is also why a first mammogram can lead to more callbacks: the radiologist has no previous images for comparison.
Murray said misconceptions and anxiety continue to influence whether people book a screening. One belief she hears is that someone without a family history of breast cancer does not need a mammogram.
“Just because you don’t have a family history doesn’t mean you shouldn’t start screening.”
Others worry about discomfort or what the examination might find.
“People have a lot of anxiety about the screening and what the results could be.”
Murray said technologists work with patients to manage compression during the examination. When a biopsy is needed, she speaks with the patient at that visit.
Ontario’s program offers screening to eligible people ages 40 to 74 without a referral. Most participants have mammograms every two years; those with extremely dense breasts are advised to return annually. People in their 40s are encouraged to discuss the benefits and potential harms with a health care provider when deciding whether to participate.
You can book appointments at Lake of the Woods District Hospital by calling 807-684-7777.
