There have been no mammogram services available to local patients since November 2019, forcing women to travel long distances for the necessary service. Prince Rupert breast cancer survivor, Laurie Cullin, on July 4, 2020, has missed her annual breast cancer imaging due to lack of services available in the city. (Photo: K-J Millar/The Northern View)

There have been no mammogram services available to local patients since November 2019, forcing women to travel long distances for the necessary service. Prince Rupert breast cancer survivor, Laurie Cullin, on July 4, 2020, has missed her annual breast cancer imaging due to lack of services available in the city. (Photo: K-J Millar/The Northern View)

New mammogram technician for Prince Rupert, but E.T.A. unknown

Women are foregoing mammograms due to travel to Terrace

A new mammogram technician is on the way to Prince Rupert Regional Hospital, announced Northern Health on July 4.

The hiring is done. The E.T.A., however is unknown at this time due to COVID-19 restrictions and training timelines, Dr. Jaco Fourie Medical Lead for Northern Health Cancer Care, told The Northern View.

A lack of radio-technologists in Prince Rupert has many women concerned about the state of their health with being unable to obtain mammogram services in the city since November 2019.

“More recently we have had a shortage of mammography technicians and because of COVID the training of the mammography technician was interrupted. As a consequence the whole process got delayed,” Fourie said.

The lack of services has forced women to travel the 140 km and up to two hours drive to Terrace for diagnostic imaging. Some women are foregoing the health services due to travel, time off work, comfort zone, climate conditions and time of day, Laurie Cullen, Prince Rupert resident said.

Cullen is a breast cancer survivor of 20 years, and has missed her annual May diagnostic imaging due the recent predicament in the city. She previously had surgery, chemotherapy, and radiation and relies on the annual imaging for good health.

Cullen’s doctor sent a referral through to Mills Memorial Hospital in Terrace for the imaging to be completed. When she hadn’t heard from them she followed up herself.

“They are just so backlogged right now I probably won’t get in there until late August … She (booking staff) doubted that it would be before August. So, I don’t have an appointment at this point.”

This is the first year that Cullen has had to contemplate traveling to another city for the examination. She said there has always been a well trained technician in Prince Rupert who she was very comfortable with.

“When I talked to the girl in mammography in Terrace whether or not I could go to the mobile unit, she said ‘No’, I needed to have the radiologist present.”

“It is a worry for me … it is definitely frustrating. Being a breast cancer survivor, I’ve spent many years trying to promote awareness to women in our community. They (the hospital) are going to miss some of the diagnoses because there is no-one here.”

Cullen said some of her friends and people she knows are postponing the important examinations and waiting until a technician is available in Prince Rupert.

“So, what is happening in Rupert right now is a human resources gap which translates into inconvenience … but it’s temporary and this will be solved,” Dr. Fourie said.

During COVID, both the mobile breast screening unit and the hospital screening were discontinued province wide and services have only just recommenced.

“The training of the mammography technician … has resumed. The expectation is that she will be starting operations in the next few months,” Fourie said. “We don’t have an exact E.T.A. because everything just started. It all depends on how quickly we can get her trained.”

“She will be based in Prince Rupert and taking care of Prince Rupert women.”

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Fourie explained there are two different streams of breast cancer screening and diagnosis, which can be confusing to those that haven’t gone through the process.

Screening for those who have no symptoms, such as abnormal signs or skin changes, but are in the focus age range of 50 to 74 can use the mobile imaging unit for their ‘screening mammogram’.

However, anybody with any symptoms and it’s not always a lump Fourie said, it can be anything that looks remotely suspicious, would use the ‘diagnostic mammogram’ stream.

“The type of mammogram they get is different because it focuses on the area of concern. It comes from different angles and it takes longer. That’s called a diagnostic mammogram.”

Fourie said another difference is for screening purposes, a patient can phone either the mobile imaging unit or the radiology department at the hospital – when there is a technician, to book themselves in for a mammogram. Alternatively, if there are any concerns, patients should attend their doctor.

“Your physician has to fill in a specific form that goes to a radiology department that has the necessary infrastructure and necessary manpower and they will do the diagnostic mammogram. That often is supplemented by ultrasound … so it’s a different environment … Women with worrisome findings will often go to biopsy on the same day.”

“So what is happening at the moment though, is because you do not have a mammography technician in Prince Rupert, your physician will probably send you to the nearest site, which is Terrace.”

Fourie said he knows for a fact that when women come into Terrace from afar, like from Prince Rupert, the hospital staff “will bend over backwards” if biopsies are required and will have them completed in the same day visit.

Fourie wanted to make it clear to women, that the screening and diagnostic processes are streamlined for health and safety of patients. If a screening mammogram, such as one in the mobile unit, shows any abnormalities or areas of concern, it is sent immediately to the closest radiology department.

“We are able to fast-track women through the Northwest diagnostic program … We can bring a woman in from Prince Rupert and within 72 hours will have her completely staged in Terrace … we get her through the medical imaging, get her a consultation with myself or my substitute and often we will get them to see a surgeon in a really really short period of time … We get the oncologist involved with 48 to 72 hours.”

British Columbia is the first province to have an integrated breast cancer screening program and as a result, Fourie said, B.C. women do extremely well. For women not to go to screening because there is a different system currently in place is very worrisome for him.

Women are encouraged to have screening and should not neglect a mammography, Fourie said. Screening technicians, such as in the mobile units, can do up to seven times more mammograms than a local hospital technician.

“They are really good at it. It is a highly, highly, efficient service that is served by well trained people … they would have more experience than the average hospital based mammography technicians, because they do other things too.”

While one in eight women will be diagnosed with breast cancer, Fourie said specifically, in British Columbia women do extremely well once diagnosed because of the integrated breast cancer screening program.

“Timelines matter. If you leave it too long women come to harm. Size matters in breast cancer and the bigger the tumour the more likely it is going to reoccur even after treatment. So the sooner we find these tumours, the better. Women should not neglect screening mammography,” Fourie said.

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K-J Millar | Journalist
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