Status of Women committee  I'll be brief. I think one big gap that I would like to identify out loud, and I can send more information, are the disutilities that are used to assess the quality of life that is gained with early detection. I was looking at this recently for the disutility.... If you treated someone for a cancer in health economics, you'll apply a certain, “What percentage of quality of life are they living during that treatment period?”

Status of Women committee  No.

Status of Women committee  In discussion with one of my colleagues, part of the issue with a lot of these studies is that the end point perhaps is not the right end point we need to look at. The end point is often a hard end point of survival, instead of looking at the stage migration that we achieve with early detection.

Status of Women committee  Sure. I'm not a surgeon, but I do see a lot of patients with early-stage breast cancer. The current guidelines for surveillance after a breast cancer diagnosis is annual breast imaging of both breasts. Having a singular breast cancer diagnosis does increase your risk of having contralateral breast cancer, so for our breast cancer survivors, our recommendation is to have annual mammography screening for, essentially, the rest of their lives.

Status of Women committee  Family doctors in Canada go through four years of medical school and two years of residency training for their specialty. They have extremely limited exposure to any sort of education around oncology, and breast cancer is no exception. At the University of Ottawa, they get about one week of oncology lectures in their time during medical school, and there is no mandatory training in oncology.

Status of Women committee  Absolutely. I do think that this discussion around screening and health screening is an opportunity for us in Canada to think about more meaningful health care reform. We can think of what the evidence-based ways are that we can help save lives and about how we can skip that step outside of a primary care provider, because our family physicians are burning out.

Status of Women committee  Thank you. Honourable members, thank you for your invitation to testify today on breast cancer screening. As a medical oncologist as well as a 41-year-old woman, concerned for both the well-being of my patients and the health of my generation, I was deeply disappointed with the draft report from the Canadian Task Force for Preventive Health Care last month.