A 35-year-old Regina woman has been waiting months to find out if she has breast cancer. As recently as last week she was told her breast biopsy was delayed yet another month, and her fear and frustration build with each delay.
Lindsay Rogers, who has a family history of breast cancer, found a lump in her left breast in April.
On June 16, her doctor found another lump in her right breast. He immediately referred her for an ultrasound. Despite her doctor’s persistence and concern, Rogers did not get her ultrasound until Aug. 17. The Saskatchewan Health Authority says screenings, like ultrasounds, fell behind during the pandemic and that a backlog still exists.
Rogers received her ultrasound results on Aug. 20. They revealed she needed a biopsy on her left breast, as the lump had grown since it was detected and because of her family history.
A biopsy would reveal if the lump is cancerous, which would put her on the road to treatment and possibly surgery. The lump on Rogers’ right breast was not seen as urgent.
Rogers’s doctor put through a breast biopsy referral on Aug. 23. Rogers was told the biopsy would take place within two weeks, which is standard in Saskatchewan, but that window was soon extended to four weeks. This initial delay left Rogers anxious about her health.
“At first I was in the denial stage. [Now] I’ve been really trying hard to stay in the anger stage, because if you go to the acceptance phase, you stop fighting,” Rogers said.
“The more and more I learn about everyone else’s stories who are going through this as well, I just have to fight harder.”
Rogers said this attitude keeps her strong and she depends on that strength.
5 weeks and counting
At five weeks post-ultrasound, Rogers still had no biopsy appointment. She said she reached out to the Ministry of Health to inquire about the wait times and was informed that the Breast Assessment Centre at the Regina Pasqua Hospital was still working on referrals from the end of July. Another month was added to her wait time.
Rogers is adamant that she does not blame the health professionals for the backlog.
“They are so backed up. They can’t do anything about it. They can’t push people closer. And you know what? For everyone they push closer, they have to leave someone else behind. And that’s not OK.”
I’ve been really trying hard to stay in the anger stage, because if you go to the acceptance phase, you stop fighting.– Lindsay Rogers, Regina
On Sept. 21, Rogers again saw her doctor, who confirmed the lump on her left breast had grown substantially in the five weeks since her ultrasound appointment. Rogers’s doctor made a second breast biopsy referral, which included an update about the urgency.
Meanwhile, Rogers said she spoke with a representative for the Ministry of Health who told her that if she were to get her breast biopsy out of province, the procedure and travel would not be covered by the Saskatchewan government.
“Being here in Saskatchewan feels like you’re not living in Canada, where health care is supposed to be accessible. When you feel like you have to go elsewhere, in order to just get a diagnosis … it’s bad. It’s really bad,” Rogers said.
As of Oct. 25, Rogers does not have a biopsy date. She has been told that it may be in the third or fourth week of November, which would mean she’d have waited three months since the initial referral.
Rogers told CBC she is feeling more physically tired as the weeks pass.
2nd round of breast cancer
Regina resident Cheryl Harvey, 59, was first diagnosed with breast cancer in 2010. She joined clinical trials at the time, and has since been monitored by the Allan Blair Cancer Centre in Pasqua Hospital. She gets a mammogram each year.
On Aug. 21, Harvey had an irregular mammogram result. The very next day the Allan Blair Cancer Centre put in a referral for a breast biopsy. Three weeks went by, and Harvey didn’t receive a call for an appointment date. This was nothing like her first time 13 years ago, where that period was under two weeks.
“Me having cancer before … I was a little panicked, and because of my past experience, I was going, ‘What is happening?”
An oncologist at the cancer centre then contacted the Breast Assessment Centre where biopsies are conducted, telling them that Harvey needed to be bumped up the list.
Another week passed, and Harvey still did not have a biopsy appointment. She said it was scary.
“Once you’ve lived through cancer and you’ve lived through having to go through that treatment … it’s the most horrible thing to know that you’re probably going to have to relive it, but you need that confirmation,” Harvey said.
“I got my will in order. Literally everything in my head is going, ‘OK, this is the end.’ And having to wait, it’s the worst possible feeling because you don’t know what you’re dealing with.”
I got my will in order. Literally everything in my head is going, ‘OK,this is the end.’– Cheryl Harvey, Regina
The oncologist then spoke directly with a radiologist and got Harvey in for an MRI, which detected there was indeed cause for concern. After that was done, there was more urgency for Harvey to get a biopsy and she was pushed through.
Harvey waited a total of five and a half weeks between getting the biopsy referral and getting the actual biopsy on Oct. 4, despite being a cancer survivor.
It was confirmed that Harvey once again has cancer. She is set to get a mastectomy in November. Harvey said she feels terribly for those like Rogers who do not have a cancer clinic advocating for them like she does.
Shortage of radiologists
In a statement to CBC, the Saskatchewan Health Authority (SHA) said that between Jan. 1 and Dec. 31, 2019, there were 1,255 breast biopsies performed in Saskatchewan. Between Jan. 1 and June 30, 2023, there were 1,028 breast biopsies performed.
The SHA said it is working to get CBC the general wait times for these two periods, but was not able to provide it by the given deadline.
CBC Saskatchewan reached out to the Government of Manitoba to inquire whether they are dealing with a breast biopsy backlog as well. In a statement, Manitoba said its Diagnostic and Surgical Recovery Task Force (DSRTF) has not identified breast biopsy as a service with either a backlog or concerning wait times.
Saskatchewan Minister of Health Everett Hindley told CBC that a reason for the backlog is a shortage of medical radiation technologists and specialized breast radiologists who can provide breast imaging services, including breast ultrasound and breast biopsies.
“I’ve been talking to our officials within the Ministry of Health to get a better understanding of what else do we need to do beyond the hiring of more staff. What else do we need to do for that system to make sure that that people aren’t waiting for weeks. People need that certainty,” Hindley said.
Meanwhile, the SHA said a nationwide supply shortage of radiologists is currently having a more pronounced impact in Regina than in Saskatoon. All breast radiologist positions in Saskatoon are currently filled, but there are three specialized breast radiologist positions vacant in Regina.
“The SHA has increased access by extending hours of service, used overtime and locum support to backfill shortages,” it said. “Work to recruit these specialized technologists is an important part of the human resources plan of SHA’s department of medical imaging and is a priority with ongoing SHA and Government of Saskatchewan recruitment efforts.”
Saskatoon family physician Dr. Adam Ogieglo said he would like to see regular progress reports on how the human resources plan is working.
“Anytime you’re waiting with the potential for a cancerous lump is very stressful, and I’ve navigated that with patients, I’ve navigated that with family members. It’s not a good place to be,” Ogieglo said.
“We need access to the biopsy more quickly and pathology results. We need all cylinders firing to make sure people are getting the care that they need.”
As for 2023 wait time standards, the SHA said it is currently striving to provide breast biopsies within three weeks for the most urgent patients, and within six weeks for other patients.
Fixing the problem
Minster Hindley said he has received many letters and has been meeting with former and current breast cancer patients about what the process has been like for them, from detection to treatment to surgery. Both Rogers and Harvey are scheduled to meet with him next week to discuss the biopsy wait times.
Hindley said he is committed to figuring out a way to shorten the wait times.
“I’m concerned as the minister of health that our wait times are what they are for biopsies,” said Hindley. “Just know that this is a priority for us as a government and we take each and every one of these individual cases seriously. We know that time is of the essence. This has our attention.”
Meanwhile, Rogers said she wants more than words. She wants to see the health ministry learn from those with boots on the ground.
“Ask the people who work in the health-care field. They are the professionals — the people who have worked very hard for many years establishing their careers so they can save lives. Ask them, and then listen to them,” Rogers said.