Colleen O’Neil Blindsided by Breast Cancer Diagnosis at Age 53

colleen GolfingColleen O’Neil says she was blindsided by the diagnosis, at the age of 53, of breast cancer.
“There’s no family history, I’ve always been healthy, and I didn’t have any of the risk factors,” said the 61-year-old.

Lots of women discover a lump, she notes. But for many, breast cancer – including ductal carcinoma in situ, the most common type of non-invasive breast cancer and the type O’Neil had – only shows up in a mammogram, as what she calls “little grains of sand.”

B.C. has one of the best screening mammography programs in the country. Established in 1988 by the BC Cancer Agency, the 25-year-old Screening Mammography Program of B.C. was the first population-based screening program in Canada for the early detection of breast cancer.

Over the program’s life, the country has seen significant improvements in early detection and, consequently, survival rates of breast cancer.

“We have very good statistics showing that the survival of women with breast cancer has benefited from this program, that survival has in fact gone up, and that there’s been a 25 per cent reduction in breast cancer among women screened in the program,” Dr. Christine Wilson said.

Wilson has been doing diagnostic imaging for more than 30 years and has worked exclusively in breast imaging since 1999.

More than 157,000 women diagnosed in the past 10 years in Canada are still living, according to the Canadian Breast Cancer Foundation. B.C. has the highest survival rate of breast cancer in Canada: 89.1 per cent of women diagnosed between 2005 and 2007 have survived five years. (The five-year survival rate for Canadian women diagnosed with breast cancer is 88 per cent – in 1986 it was 79 per cent.) Since peaking in 1986, breast cancer-related deaths in Canada have decreased by 42 per cent due to earlier detection through regular mammography screening, advances in screening technology, and improved treatment of cancers.

Wilson, now medical director of the Screening Mammography Program of B.C., began the first MRI-guided breast biopsy service in the province in 2006 at the BC Cancer Agency. That technique uses magnetic resonance imaging technology to precisely guide the biopsy needle to where a suspected cancer is to be sampled for testing.

“We have the best, longest-running screening mammography program in the country,” she said.

One in nine women in Canada is expected to develop breast cancer in her lifetime. In 2013, that means an estimated 23,800 women are expected to be diagnosed with the disease. The risk increases with age: 82 per cent of breast cancers occur in women over 50.

In B.C., women between 40-79 can get a mammogram without a physician’s referral. Women over 79 need a referral. B.C. women in the 50-79 age group are sent a reminder every two years. Women in their 40s are sent a reminder every year.

The message Wilson and the BC Cancer Agency want to spread is clear. “Basically, we want to emphasize that mammography helps find breast cancer early,” Wilson said. “We want women 50-79 to be aware of that. And that in B.C. screening is also available for women in their 40s.”

Most women in their 30s of average risk don’t need to be too concerned about having a mammogram, she said.

“However, women who have a very strong family history of breast cancer, particularly early, need to bring that to their family doctor’s attention,” Wilson said.

“If the family history is strong enough, there are genetic screenings available. If they are found to be BRCA1 mutation positive, they would become part of that high-risk screening group and we do have a specific clinic available for them.”

Earlier this year, actress Angelina Jolie, 37, was in the news for undergoing a double mastectomy due to the presence of the BRCA1 gene in her family.

There was some history of bowel cancer in O’Neil’s family, but no breast cancer. She hasn’t taken hormone replacement treatment or taken birth control pills for lengthy periods of time. Both are considered risk factors because they contain estrogen, which feeds cancer cells.

O’Neil had been getting annual mammograms during her 40s, and then every two years when she turned 50.

After her mammogram at 53, “they thought they saw something,” she said.

She was diagnosed following a biopsy. O’Neil’s cancer cells were fast-growing grade III cells.

“I had it in three places in one breast,” she said. “I couldn’t really have a lumpectomy because I would’ve lost most of my breast anyway. So I had a mastectomy.”

The mastectomy, she says, was considered a 98 per cent cure in her case.

“On the other hand, they do say once you’ve had a cancer diagnosis you are at a higher risk than just Joe Blow on the street,” she said. “So they watch my other breast carefully.”

For five months following the mastectomy, she went for a mammogram every six months. She now gets one annually.

O’Neil runs the Caring Circle Health Resource Centre on Bowen Island. She has also received a Citation of Merit from the Canadian Cancer Society for her peer-support work.

“I do believe I would not be alive today if I hadn’t had the mammogram when I did,” she said. “Had another year gone by, those cells would likely have gone elsewhere, to my lymph nodes, and could have metastasized in other places in my body. Would I still be out here golfing and having a great life eight years later? I’m just not sure I would still be alive.”


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