By Anna Robertson and Hannah Sabourin
Imagine the terror of finding a lump in your breast. Perhaps for the first time, you confront cancer as a real possibility in your life. Fear and panic are normal responses to such an event. Now imagine, in that state of stress, having to wait more than 30 weeks for testing and results.
That is the situation facing many women in the Outaouais — one in eight who will have to deal with a breast cancer diagnosis in their lifetime, according to the Pink Ribbon Foundation of Quebec.
In September, a La Pêche resident in her early 40s recently discovered a lump in her breast. (For privacy reasons she said she prefers not to have her name published.) She moved to Quebec from Europe five years ago and explained that, when she found the lump, she was terrified.
“You try to be rational and at the same time you wake up in the middle of the night worrying,” she said.
At first, she said she wasn’t actually that worried about outcomes. She explained that she felt the healthcare system was here to support citizens and that she would be taken care of. She said she told herself: “OK, even if it’s cancer, I live in a developed country. I have access to hospitals nearby and everything will be fine.”
And everything was fine — at first. Although she didn’t have a family doctor, she was able to get an appointment at the Wakefield Hospital. The doctor there suggested she get a mammogram, a type of x-ray used to detect and diagnose breast cancer. She discovered that there were only three places to get a mammogram in the Outaouais: one was at a private clinic and the other two were at hospitals in Gatineau and Hull. She went with the private clinic and she said the appointment was scheduled quickly and professionally executed. She was told that she would get her results in two to four weeks.
That was when the trouble started, the woman explained. While waiting for the results, she discovered another lump. She said she spent several hours on the phone trying to contact the clinic. She ended up going back to the clinic in person and asked for her mammogram images. Feeling impatient waiting for her official results, she ended up sending her images to an online service in India for interpretation. She said she was told by the online service that her breast tissue was “dense,” making the mammogram difficult to read and that she would need an ultrasound.
She explained that she spent hours on the phone trying to make an ultrasound appointment. She was told the wait would be 16 to 18 months in the Outaouais and two months in the Pontiac region. She tried Ottawa and Montreal and discovered that, because she had had her mammogram done elsewhere, the clinics would be unable to help her.
The website inspq.qc.ca lists Quebec wait times by region for obtaining a mammogram and additional breast imaging appointments. While wait times in many regions range from one to four weeks, in the Outaouais wait times are “more than 30 weeks,” according to the website.
She said she is perplexed by the dichotomy of messaging by Quebec health authorities. On the one hand, she said they are trying to raise awareness about breast cancer and are encouraging early screening, while at the same time service is disconnected and limited at best.
“It’s really hard to understand why the situation is so bad here compared to other areas in Quebec,” she commented.
She said she is left with a lot of questions: why is this region so much worse than other regions in Quebec? Are women meant to sit back and wait patiently for tests and results? Are they meant to travel outside of the Outaouais for help? How can they be expected to deal not only with the stress and anxiety of a potential breast cancer diagnosis, but also with unclear messaging and agonizing wait times?
A 2018 Institute for Socioeconomic Research and Information (IRIS) report found that the Outaouais was underfunded by $250 million compared to similar regions in Quebec.
Zied Ouechteti, assistant director of the Direction des Services multidisciplinaires et à la communauté (DSMC) a division of Centre intégré de sante et des services sociaux de l’Outaouais (CISSSO), said that they attribute long wait times for testing and results to staffing shortages. He confirmed that there are many vacant positions in the facilities that offer breast cancer screening services. He added that routine breast cancer screening was halted in the Outaouais during the pandemic, which has created a backlog.
In the end, the La Pêche woman we spoke with went back to the first clinic and has just confirmed that an ultrasound appointment has been booked for the coming week. She has also just received her mammogram results after four and a half weeks. This was after two phone requests, one in person request and a formal request from her doctor. She said the results are encouraging and it looks like the growths in her breasts are benign cysts and not cancerous.
“I’m lucky; I have enough money to explore other options; I have a supportive husband; I was able to take time off work to deal with everything; I have an education, which allowed me to be able to navigate the medical system. But what about people who aren’t so lucky?” she asked.
By agreeing to be interviewed about this topic, she said she hopes that Outaouais women will share their knowledge and experiences with each other and together put pressure on healthcare authorities – including the region’s politicians – to improve the breast cancer screening situation in the region.
Despite multiple attempts to reach the region's MNA Robert Bussière, for comment about breast cancer screening wait times, he did not respond to the Low Down's questions.