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I was diagnosed with stage 1 invasive breast cancer in July 2015. Although I was devastated with this diagnosis, I was pleased to find out that I was a candidate for the Oncotype DX test due to the characteristics of my tumour.

The Oncotype DX test determines the likelihood of cancer recurrence and whether or not the risks of chemotherapy would outweigh the benefits for a particular individual. I was shocked and very disappointed to find out that Nova Scotia’s MSI program does not currently cover the Oncotype DX test, despite the fact that research has shown it to be a very effective test and many other Canadian provinces do cover the cost of this important test.

I believe that Nova Scotians deserve to have the Oncotype DX test done if their oncologist feels that they could benefit from it. I did end up having the Oncotype DX test done and it definitely changed the course of my treatment for the better. I received a low score on the test which meant that I would NOT benefit from having chemotherapy. As you could imagine, this was a huge relief for both myself and my family.

I am a mother of 2 young children and if I were to have unnecessarily undergone chemotherapy it would have negatively impacted both my family and society as a whole as I would have been unable to work for the last 6 months. As it turned out, I was only off work for 3-4 weeks.

I believe the cost of the Oncotype DX test would pay for itself several times over in savings from unnecessary medical expenses, as well as increased tax revenues from patients being able to quickly return to work, as I did. Chemotherapy is toxic and has many side effects that often lead to future health problems which would put financial strains on the Nova Scotia health care system in the years to come.

In addition, I saw my oncologist in November and he discharged me from his care since I did not end up needing chemotherapy. Thus, freeing up the healthcare system for people that need it and saving MSI money, as I no longer need oncology followup appointments since I did not have chemotherapy.

I think that the Nova Scotia government needs to realize that the Oncotype DX test can save the province significant amounts of money in the long run not to mention the mental and physical anguish it can save breast cancer patients. I am very thankful that I had the Oncotype DX test and feel that other Nova Scotians deserve the opportunity to be spared the toxic effects of chemotherapy which in turn will also save the province money rather than being a penny wise and a pound foolish.

Sincerely,

Sarah (a breast cancer survivor)

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Not a single day goes by where I’m not thankful to live in Canada with access to healthcare for all. Like most Canadians, I strongly support our health system’s public rather than private structure. In fact, I’m extremely proud of our system. Pride aside, my role as the head of Rethink Breast Cancer, a national breast cancer organization leading the young women’s breast cancer movement, has opened my eyes to the disparities in care between the provinces and within provinces. And, my charity’s focus on young women in particular has shown me that despite our incredible health care system, the unique needs of young breast cancer patients still fall through the cracks.

Last week, Rethink hosted a workshop looking at the breast cancer experience for young women. I spent the day with twenty young women, all from different parts of Canada and all at different stages of their cancer journey. During the pre-meeting breakfast, I overheard one group chatting about children, daycare and schools — typical young mom stuff. Later on, one young woman mentioned a passion for cake decorating, another was planning on hitting Toronto’s vintage clothing shops the next day in search of a distinctive wedding dress, and another woman, almost seven months pregnant, was chuckling about taking time off from wining and dining. There was obviously a lot of discussion about breast cancer — managing lymphedema, reconstruction challenges, metastasis — but the day was another reminder that the young women we support and work with are still building their lives. Some are just finishing school or starting careers; others are planning weddings, trying to get pregnant or raising a young family. Our healthcare system needs to consider these young women’s lives and not just their tumours.

Young women with breast cancer present our healthcare professionals with difficult cases. They are often diagnosed with aggressive forms of breast cancer that require tough therapies. And the powerful treatments needed to stop the cancer can cause many complex side effects for young women, including early menopause. Because of their life-stage, young breast cancer patients also have many unique practical and psychosocial needs, everything from childcare and financial challenges to feelings of isolation and being overwhelmed by facing huge life decisions earlier than planned.

To help improve the lives of young women with breast cancer, Rethink Breast Cancer, is launching ten Care Guidelines for Young Women with Breast Cancer. These guidelines are a powerful tool for both healthcare workers and young patients to use to uphold the Canadian mandate of healthcare for all, and ensure the very best care for young women with breast cancer.

I know many outstanding breast oncologists, surgeons and oncology nurses who make up healthcare teams that are treating and caring for young women as young women, not just as cases. And, many health care professionals have immediately endorsed our Care Guidelines for Young Women with Breast Cancer because they agree with the importance of holistic care. However, our research shows that in many parts of the country, young women’s special needs are not always being addressed. That is why we have worked with both healthcare professionals and young women with breast cancer to create these ten Care Guidelines and are seeking the endorsement of all cancer centres across Canada.

Health Canada and the Canadian Medical Association have established comprehensive clinical practice guidelines for the care and treatment of breast cancer, and our provincial cancer agencies, the Canadian Association of Nurses in Oncology, and the Canadian Association of Psychosocial Oncology have all developed excellent standards of care. These are all designed to ensure the consistent care of cancer patients across our vast country. Rethink Breast Cancer’s Care Guidelines for Young Women with Breast Cancer serve as a compliment to these standards. They have been created in an effort to ensure the special needs of young women with breast cancer are addressed in a timely manner no matter where in Canada they live. Young women with breast cancer have unique challenges and needs and we need a consistent approach to addressing those needs.

Young women need our support to ensure these guidelines are universally adopted. I am calling on all Canadians to share the #CareGuidelines with the healthcare community, with young women who have been diagnosed, and with their friends and networks. Together we can close the gap in care for young women with breast cancer.