Tory MP Kellie Leitch is one of several medical doctors sitting in the House of Commons who bring a unique vantage point to the debate on breast cancer screening guidelines.J.P. MOCZULSKI For The Globe and Mail
When Kellie Leitch was 18, her mother died of breast cancer. As devastating at that was, she says she was "lucky enough" to have a father who talked to her and her sister about the importance of examining their breasts and screening.
"This, as you can imagine, is a tough conversation for a single dad with two daughters under the age of 20," recalls the 41-year-old rookie MP for Simcoe-Grey.
But, she adds, it's one that "should be happening in every home across our country."
Her memories were triggered this week by controversial new guidelines on breast cancer screening from the Canadian Task Force on Preventive Health Care.
These new guidelines dismiss much of what women have been taught over the years. Breast self-examination and clinical examinations have no benefit and are not recommended, according to the new rules. As well, women under 50 should not have mammograms and women 50 to 74 should have them only every two to three years. The new directives do not apply to women considered high risk.
No surprise then that this new edict has provoked much emotion and sparked an important and very personal debate.
Even on Parliament Hill, women MPs are divided, differing on how they handle their own breast health and on the new guidelines. Some are simply confused.
But not Interim NDP Leader Nycole Turmel. She doesn't agree with the changes.
There are just too many stories she has heard from – and about – women under 50 who have discovered a lump after doing breast self-examinations.
"I find it sorry and sad that they changed this," says the 69-year-old Quebec MP, who has regular mammograms and does self-examinations.
There is no history of breast cancer in her family. But she worries that because of these new rules, women with no familial history of breast cancer, but who have concerns, will be shunted to the back of the line for screening.
Ms. Leitch, meanwhile, is one of several medical doctors sitting in the House of Commons. So, she and her colleagues approach this issue from a unique vantage point – able to marry their expertise with their ability now to influence the public debate.
"My personal and family experiences, as well as my experiences as a doctor, have profoundly shaped my views on this issue," Ms. Leitch says, adding that her mother, Lynne's, illness and death were among "the most significant events to shape my life."
She says breast cancer screening is "vitally important" and calls the new guidelines "valuable for average-risk women."
"But it is important to keep in mind that it is a guideline, and women should work with their doctors to decide what is best for them," she cautions. "These guidelines are not a substitute for the discussion that women need to have with their doctors."
Like Ms. Leitch, Carolyn Bennett, a Toronto Liberal MP, is a medical doctor. She supports the guidelines, arguing they are backed up by evidence. As well, there is a need, she argues, to "reduce radiation and cost and needless worry of false positives."
She also lost her mother to breast cancer and so is screened regularly and does self-examination, but she notes she has had "alarming mammograms that required ultrasound and MRI follow-up to prove the 'spot' was not cancer."
Subscribing to the view that a woman discusses all this with her doctor is Lisa Raitt, the Labour Minister. Although she hasn't been following the debate over the new guidelines, she says she follows the advice of her doctor. And so far, it's been regular mammograms and self-examination.
"But I know early detection is key so I make sure I check frequently," says the 43-year-old politician.
Others, however, are less attentive. Megan Leslie, the 38-year-old NDP MP for Halifax, falls into that category.
"I'm of an age where included in my 'Welcome to University!' frosh kit was a plastic hanger for the showerhead with instructions on doing self-examination," she says. "A few years later I read media reports saying that self-examinations were not very useful, so I stopped doing them."
Ms. Leslie says she gets involved in breast-cancer fundraisers including Run for the Cure and an event called Titz 'n Glitz, but she admits she's not so careful when it comes to herself. "I have done little to take action for my own breast health."
The new recommendations may be fine, she says, but they make things confusing.
"Do I self-exam? Do I get a mammogram? How often? It can be hard to decipher what it is I need to do if I want to be proactive about my health," she says.
Ms. Leitch, however, can't stress enough the importance of awareness for screening: "Much of the important work for increasing awareness should happen not only at the doctor's office, but also at home."