Women fought long and hard to have the Breast Screening and Assessment Service established at Health Sciences North and they are picking up the torch again to make sure that service is not dismantled.
HSN senior leaders have announced plans to eliminate the assessment or surgical part of the service to save $270,000 a year as they struggle to reduce an $11-million deficit.
Every program, service and treatment in the Sudbury hospital system is being put under a microscope to determine if it can be eliminated, trimmed or its services transferred to an organization in the community.
Anne Matte gets that hospital leaders have to make tough decisions to balance the books. But she is blunt about how they are doing it in at least this instance.
“Unfortunately they picked the wrong (program),” said Matte, the first registered nurse to work with the hospital’s breast health program, the precursor to the Breast Screening and Assessment Service.
Matte explained the assessment or surgical part of the service is where women are referred if screening shows they have breast abnormalities. Sudbury’s three breast surgeons work in a clinic at the BSAS and women are quickly booked for a consultation with them by the service’s nurse navigator.
Hospital officials have been clear that the screening part of the program, which costs $1.6 million to run annually, is not being cut and that women will still have mammograms, ultrasounds or other screening tests at the service located on the fifth floor of the Sudbury Outpatient Centre.
But breast surgeons, nurses who have worked for the service and women who have been treated there say eliminating on-site surgical consultations is gutting the program, and will result in longer wait times to see a surgeon and poorer health outcomes.
HSN officials have met with surgeons outlining their expectation that women will be referred after screening and biopsies to surgeons in their private offices in the community. In a statement issued after last Thursday’s meeting, HSN said it will continue discussing the cuts to the program with surgeons and working on a way to expedite the referrals from the screening program to surgeons.
Breast surgeon Dr. Rachelle Paradis has spoken out against the change in the service saying her downtown office is busy and it will be difficult to accommodate more patients there. Matte said about 2,000 new referrals are made to breast surgeons every year about breast abnormalities. About 10 per cent of those will be women diagnosed with breast cancer.
Matte was one of the founders of a group called the Breast Action Coalition, formed two decades ago to lobby for better breast health services for women. The group wound down five years ago when the Breast Screening and Assessment Service was running smoothly, said Matte, who retired from hospital nursing and now works at the Hanmer location of the Centre de santé au communautaire.
Many of the original members of the coalition are reuniting, calling themselves concerned citizens rather than activists, and are launching a letter-writing campaign to convince HSN it is a bad idea to restructure the program. Look for letters to begin circulating from them this week.
Nickel Belt MPP France Gélinas, the New Democrats’ Health critic, has started a petition calling on the Progressive Conservative government of Doug Ford to ensure northerners have equity of access to programs such as the BSAS.
Before BSAS was created, marrying screening and surgical consultations services in one, Matte said it was taking an average six months, after women had abnormal breast test results, to see a surgeon, be operated on and then referred to the cancer centre for radiation and/or chemotherapy.
That timeline was cut to about eight weeks after the BSAS was created, she said.
Research has shown the time of the highest anxiety for women is after a mammogram or other diagnostic tests show an abnormality and the time they see a surgeon. As the BSAS operates now, when women test positive for breast cancer, the BSAS nurse attends the consultation with the surgeon where women are given written information about the type of cancer they have, the size of the mass and what the next step is, said Matte.
While women are awaiting surgery or treatment at the cancer centre, the nurse at the BSAS is available to field questions and allay fears they have about their situation.
The nurse at the service also refers patients to services such as those offered by the Canadian Cancer Society and other community organizations.
Matte saw hundreds of women and a couple of men diagnosed with breast cancer when she worked at the service and she witnessed how difficult such a diagnosis is on entire families.
“Sometimes, it’s the children who are in crisis,” said Matte.
As well as triaging and linking patients to services and supportive care, the BSAS nurse educates about the disease.
Matte hasn’t had breast cancer but her mother died of it in 1999.
“Breast cancer changes your whole outlook,” she said.
She remembers the day two decades ago, before BSAS, when her mother was operated on and told in a spot in the operating room sectioned off with curtains, that she had breast cancer while Matte and her father overheard the conversation.
One of her concerns with a pared down program is how women are going to receive news about a positive diagnosis.
What Matte does not get is how hospital officials can say, in 2018, “that there is not a need (for the assessment part of the service) anymore.”
Matte, Paradis and other women took pride in establishing a program that helped so many women and their families, and which has been copied at other hospitals.
This week, many of these women received an email from The Ottawa Hospital, promoting its new Breast Health Centre. Sudbury women say it hurts to see the city’s hospital system taking a giant step backward.
In part, The Ottawa Hospital news release reads, “The Breast Health Centre … is a comprehensive breast centre that offers expertise in breast imaging, diagnosis, risk assessment, surgical planning and psychosocial support in a caring and efficient environment for individuals with breast cancer and other breast concerns.
“The BHC features new, state-of-the-art equipment and will provide a more efficient and comfortable experience for those going through diagnosis and/or treatment. It’s a revolution in breast health that will benefit patients in our region.”
Carol Mulligan is an award-winning reporter and one of Greater Sudbury’s most experienced journalists.
