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Why doctors say breast cancer screenings need to happen at a younger age, especially for Black people


When Patricia Russell was in her late 30s, she felt a lump in her breast. She knew the texture, the feel of the lump, was not normal.

“I was at a stage in my life where I wanted to take charge of my health. But I wasn’t expecting (breast cancer), I wasn’t looking. As a matter of fact, I’m one of the women who said, ‘This will never happen to me,’” she said at a news conference Thursday.

But after finding the lump, Russell began examining herself and found what felt like may have been a mass.

“'This feels weird, this is not normal.' (But) I wanted to push it off,” she said. She fought that instinct and went to get examined, and ended up being diagnosed with breast cancer.

Since that fateful day, Russell has survived two bouts with the disease. Now, she is part of a campaign launched this week with Toronto-based lingerie company Love & Nudes to not only raise awareness about breast cancer in Black people, but to urge the federal government to lower the age of breast cancer screening programs across the country to include those who are 40 years old so that more people of colour can have cancer detected earlier.

Russell spoke at the news conference with other breast cancer survivors and doctors, who discussed health disparities and why Black people, who have worse outcomes when it comes to breast cancer, are being screened less for the disease and are up against a health-care system they say promotes resources that are centered on white people.

Canada does not routinely track race-based data around breast cancer screening rates, but other Western nations have shown Black people have clear, poorer outcomes when it comes to breast cancer.

In the U.S., Black women are 40 per cent more likely to die from breast cancer, and the figure has remained that high for over a decade, according to the American Cancer Society (ACS).

As well, Black women younger than age 50 had a death rate that was twice as high as white women at that age, according to the ACS. The group states that screening rates have not increased and racial disparities in screening rates need to be addressed to fix the issue.

According to 2021 data from the federal government and the Canadian Cancer Society, cancer screening rates are lower for racialized people, who face multiple barriers to screenings, and late diagnosis results in poorer outcomes and a lower survival rates.

The COVID-19 pandemic has also disproportionately impacted Black people due to structural racism and neglect of communities, meaning that these challenges to getting screened have likely been made worse, the report states.

As well, the report notes that two-in-five Canadians will develop cancer in their lifetime, and about a quarter of all Canadians will die from cancer in their lifetime. For women in 2021, breast cancer was the most common cancer diagnosis, making up 25 per cent of the close to 111,000 cancer cases found in women that year. The Canadian Cancer Society also estimates about 15 women die of breast cancer per day in Canada.


Love & Nudes, a lingerie company founded in 2017 by entrepreneur Chantal Carter, sells nude underwear that matches the skin tones of racialized women. Carter told in a phone interview Thursday that traditional “nude” colours in lingerie too often are designed with only white people in mind.

This image provided by Love & Nudes shows the insert the lingerie company plans to provide to customers, to show how a cancerous lump could present on those with darker skin tones. (Love & Nudes)

For the campaign on breast cancer, the company is planning to include an insert, in multiple skin tones, with purchases in the near future that has been made to mimic how a cancerous lump might look on a person of colour. For instance, the redness that could appear for those in lighter skin tones will not be present for the example meant to reflect Black people, said Carter.

She said many people in her life have been impacted by breast cancer, and a close family friend died of the illnesses in her 40s.

“When I discovered these statistics that Black women have a mortality rate that’s 40 per cent higher than white women, it reminded me of my brand and what it stands for: representation,” she said. “The face of cancer is not usually ours.”

The collection with the inserts has been named “Stage Zero” to highlight that awareness and prevention can help keep Black peoplefrom being given a fatal diagnosis, with the hope breast cancer can be caught earlier if screenings are encouraged.

Dr. Mojola Omole, a Toronto-based surgical oncologist who is participating in the Love & Nudes campaignand helped design the insert, told via a phone interview Friday that issues with receiving a timely diagnosis are due to systemic barriers around getting screened and accessing care.

“All women, and especially racialized women, should be screened at the age of 40 and it should be yearly. You can’t be afraid of what you might find out, because you don’t want to upstage your disease,” she said.

The earlier the disease is caught, the more easily it can be treated, she said.

Across provinces and territories, mammography is used for screening for breast cancer with the goal of catching any signs or symptoms before the illness actually develops. 

Self-referrals, meaning a person can decide on their own if they are ready for a screening, are possible in B.C., P.E.I., Yukon and Nova Scotia at age 40. Alberta allows for self-referral at age 45.

In Alberta and the Northwest Territories, screenings are able to self-refer following their first breast cancer screening in your 40s and that initial screening requires a doctor’s requisition. 

According to Dense Breasts Canada, the federal guidelines stipulate that Canadian women have the right to start screening at 40, a choice based on their values and preferences, but they're encouraged to have conversations first with their family doctors.

The organization is advocating for federally and provincially for self-referral for all women starting at 40 and continuing after 74.

Within Black communities, there can be stigma around discussing cancer due to fear, said Omole.

“By ignoring it, it doesn’t go away,” she said.

People are not always getting access to information about how detecting cancer early can give someone a better chance to return to their normal life, she said.

There’s lots of misinformation online, and the health-care system doesn’t always target specific groups or address their concerns, she said.

This image shows the inserts Love & Nudes plans to send to customers to highlight how a cancerous lump could appear on various skin tones. (Love & Nudes)

Omole said inserts that show what a lump looks and fees likes, such as the ones being distributed by Love & Nudes,should be included in other spaces where people receive health care, even at their local pharmacy.

“The images can be a really powerful thing. When you don’t feel included in the conversation, you just exclude yourself, you don’t think that is a possibility for you … you think, ‘That’s a white person’s disease,’” she said.

“We don’t really educate people, that’s what’s needed in medicine in general,” she said.


This story has been updated to include more information on provincial screenings, and to clarify that women in Canada have the right to start screening in their 40s, based on their own values and preferences. Top Stories

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