Breast cancer screening in Canada: 2021/2022

Other breast screening modalities

Other modalities used in Canada to screen individuals for breast cancer are tomosynthesis, magnetic resonance imaging (MRI) and ultrasound, and their use may be dependent on a person’s risk level of developing breast cancer. Most jurisdictions use one or more of these methods to screen for breast cancer.

3D Tomosynthesis*

P/T  Used for high risk  Used for average risk   Use of tomosynthesis  Plans to implement tomosynthesis 
YT  Used on all screening exams since December 2020
NU  2D Tomosynthesis used at QGH
(research setting only)
Only used at two sites that are participating in national TMIST trial
AB  Tomosynthesis used widely with some sites on every screen and others on dense breasts only.  Province has modifier billing code.
SK  Currently used in some diagnostic settings throughout the province.
(with equipment upgrades throughout the province)
ON  Not currently recommended. However, for sites with digital breast tomosynthesis, this technology can be used as part of breast assessments. If digital breast tomosynthesis is being offered to Ontario Breast Screening Program (OBSP) participants for screening purposes, then it must be done and reported outside of the program after the OBSP two-dimensional views have been obtained. No plan to implement tomosynthesis, but Ontario Health (Cancer Care Ontario) continues to monitor the evidence.
QC  Not recommended for screening. Used in diagnostic imaging according to INESSS recommendations.
NB  Not recommended for screening. Used by some sites as supplemental investigations for individuals with dense breasts. Currently available at 2 sites. Under evaluation as part of current Increased /High Risk Guideline development.
NS  Not used in breast screening No plans to implement tomosynthesis
Plans to purchase tomosynthesis as replacement equipment within next year
(Tomosynthesis is being considered when equipment is due for replacement in 2022).

* Tomosynthesis (also known 3D mammography): emerging technology that allows the breast to be viewed three-dimensionally

MRI and ultrasound

P/T  Use of MRI in high risk Use of MRI in average risk Use of ultrasound in high risk Use of ultrasound in average risk
NU  ✓^
(Some sites use as supplemental for dense breasts or if patient cannot tolerate MRI)
(if MRI is not medically appropriate)
NB  Under evaluation as part of current Increased /High Risk Guideline development Under evaluation as part of current Increased /High Risk Guideline development

NU: ^Ultrasound is used on all patients under 35.