Manitoba should offer breast cancer screening starting at 40, says woman diagnosed at age 42

A Winnipeg woman who was diagnosed with Stage 3 breast cancer almost two years ago is pushing for the province to lower the breast cancer screening age from 50 to 40 in the hopes of saving people’s lives. 

Shannon Coates got her breast cancer diagnosis in August 2022, when she was 42 years old — seven years after she first began asking for an annual breast cancer screening and was denied.

Coates, who is now six months post-chemotherapy, told CBC’s Information Radio there is a history of breast cancer in her family, and it’s unfortunate people in Manitoba from 40 and 49 can’t refer themselves for a breast cancer screening. 

“I was angry. I was frustrated. I was upset at our health system here in Manitoba, that I had been denied,” Coates told host Marcy Markusa in a Thursday interview. 

“I think it’s reckless for women’s health that we’re not taking this more seriously.”

Breast cancer is a major health concern in Canada, with one in eight Canadian women diagnosed in their lifetime.

In Manitoba, routine screenings are recommended for women age 50 to 74, who don’t need a doctor’s referral for a screening. Routine screening mammograms aren’t recommended for women under 50 or over 74.

But that’s not the case everywhere in Canada.

Women aged 40-49 can self-refer to breast screening programs in British Columbia, Nova Scotia, Newfoundland and Labrador, Prince Edward Island and Yukon.

New Brunswick has announced it will support self-referral for that age group as of next month, and Ontario says it will do so in the fall.

Both the Northwest Territories and Alberta have recently lowered program start age from 50 to 45, and Saskatchewan recently announced that it will lower its program start age to 40, using a phased-in approach beginning in 2025.

In a 2022 study, when researchers at the University of Ottawa compared breast cancer statistics from provinces that screened women in their 40s to data from provinces that followed the task force guidelines, they concluded earlier screening led to significantly improved survival rates.

Earlier this month, the Canadian Cancer Society urged all provinces to lower the screening age. 

A woman wearing a hot pink dress sits on a hospital chair holding a sign that reads, "Round eighteen of herceptin. Sixteen of chemo Nov. 9, 2023."
‘I wish chemo on no one,’ said Coates, who is now six months post-chemotherapy. (Submitted by Shannon Coates)

However, new Canadian screening guidelines suggest that people should be able to get a mammogram starting at age 40, but it shouldn’t be routinely offered to all women under 50.

The Canadian Task Force on Preventive Health Care — a Public Health Agency of Canada-created panel of health professionals that offers guidance on creating guidelines for health-care practitioners — “does not recommend regular screenings for women under 50 who are of average risk,” a spokesperson said in an email to CBC News.

“However, the task force believes breast cancer screening is a personal choice, and that any woman who wants a screening should be able to get one.”

Nonetheless, Coates is hopeful for change. 

She was training to run her eighth Manitoba Marathon in 2022 when she noticed she had an inverted nipple, which looked abnormal to her.

When a mammogram and ultrasound came back positive for an aggressive triple-negative breast cancer, she started chemotherapy.

A woman smiles while wearing bright pink lipstick and a white turtleneck sweater in a kitchen.
Coates was 42 when she was diagnosed with an aggressive form of breast cancer. (Submitted by Shannon Coates)

Coates endured 16 rounds of chemotherapy and radiation and a double mastectomy in February last year. 

Said her first round of chemotherapy was debilitating. 

“I wasn’t able to walk, I had no quality of life. My hair fell out and [it] burned my scalp every single round. It was horrific — I wish chemo on no one,” she said.

She also estimated approximately 17 health care professionals helped during her breast cancer treatment — a significant strain on the health-care system compared to preventative measures like routine screening, she said. 

Kathleen Cook, the health-care critic for the Manitoba Progressive Conservatives, accused the NDP government of “hiding behind” the task force’s guidelines.

“Is the premier really going to stand alone on this in Canada and deny younger women the access to breast cancer screening, or will he do the right thing for Manitoba women today?” Cook said during question period Thursday.

Manitoba Health Minister Uzoma Asagwara said Wednesday the province is looking into making changes, but it first has to ensure it has the technologists and other health-care professionals who can provide expanded screening.

“I understand yes, there is a capacity issue,” said Coates. “But there is also women’s health, early screening and early detection that could help these women.”