By Adriana Ermter
In our monthly column, senior writer and editor Adriana Ermter shares her personal experiences with breast cancer.
How old were you when you first learned you were eligible for a mammogram? If you’re like me, that information only became clear after you found a lump of your own. And at that point, the rules and guidelines about when women can and can’t access breast cancer screening don’t feel relevant anymore—it’s too late. Except that it shouldn’t be. Women should know when they can book a mammogram, long before a diagnosis, as part of routine healthcare and early prevention, especially when it comes to detecting late-stage breast cancer before it advances. So why don’t we know more?
Why we don’t know the rules about getting our first mammogram:
Well, there are a few reasons. The short answer is, the information simply isn’t clear or consistent. Self-referral eligibility for screening differs across provinces and those guidelines have been shifting quickly in recent years. Maybe it’s funding, maybe it’s logistics, maybe it’s both. Keeping mammogram, ultrasound and MRI machines running, staffing clinics and hospitals and paying trained technicians, radiologists and doctors all cost healthcare dollars that can impact provincial budgets. You know, the ones our tax dollars help pay for.
What we do know, however, is that the recommended screening age used to be well established. A 1996 Statistics Canada research article states that by the late 1980s, age 50 became the standard recommendation for mammograms in Canada and most provinces adopted that guideline by the mid-1990s. And for about 35 years nothing changed, despite long-term data showing an increase in breast cancer diagnoses among younger women.
A 2024 University of Ottawa analysis of Ontario cancer data reported long-term increases in breast cancer diagnoses among younger women over the past two decades: a 45.5% increase in women ages 20 to 29, a 12.5 per cent increase in those 30 to 39 and a 9.1% rise among women 40 to 49. I am part of the 9.1%. Statistics like these highlight the gap between screening guidelines that haven’t fully caught up with the realities young women face and why so many of us feel unprepared, uninformed and/or left out of a system we all believe is there to protect us.
What’s being done to increase awareness?
Not enough. In Canada, awareness around mammogram eligibility is a see-saw split; some of us know, lots of us don’t. Organizations like the Canadian Breast Cancer Network and Dense Breasts Canada work overtime to share information and messaging through social media and the press. Unfortunately, though, unless breast cancer is part of your family history or if you’re like me, without a familial history and under the age of 50 when diagnosed, chances are you aren’t following these organizations and were sidelined with your breast cancer diagnosis.
If we were better informed by more generalized means, such as letters from the government, articles in women’s consumer magazines, posts on mainstream Instagram and TikTok channels and beyond, more women would know that nearly every province and territory (except Quebec) has either lowered or announced plans to lower the minimum screening age to 40 or 45 between 2023 and 2026. But we don’t. So much so that a 2025 survey from Leger Healthcare and the Canadian Cancer Society (CCS) found only 36% of women surveyed could correctly identify the minimum age for mammograms in their province. Among women aged 40 to 49, just one in three said they were “very aware” of the existence of breast-screening programs where they live, which means huge numbers of people who could and should be screened before age 50 don’t even know it's an option. We desperately need to change this and increase public messaging.
For decades, the common public message was that breast cancer screening began at 50. So, while the screening age and policies have recently changed, it hasn’t translated into public awareness. You know how you receive an annual letter from Cancer Care Ontario or Alberta Health Services and so on, asking you to perform and then mail in your annual fecal test to screen for early signs of colon cancer? Well, that doesn’t happen with breast cancer, never mind that there is no way to self-test this, leaving women to navigate a referral from their doctor or self-initiate their own appointment. Sadly, most of us never even get around to doing any of the above because we just don’t know that we should or that it’s an option.
What you and I can do now
First and foremost, have a discussion with your doctor about your personal risk and the best time to start routine screening. If you’re 40 or over, learn about self-referral eligibility in your province. While the survey from Leger Healthcare and the CCS found that in 2025, 89% of Canadian women aged 50 to 74—the traditional screening group—reported having had a mammogram, only 52% of women aged 40 to 49 say they have ever had one. According to Leger, and I agree, this is bad news. Because when a significant number of eligible women are unaware that they can even book an appointment to screen for breast cancer, opportunities for early detection get missed.
Designate your donated cancer dollars to awareness
That’s why increasing funding for breast cancer screening awareness needs to be just as urgent as funding research for treatments. Donating to research labs and clinical trials helps advance therapies, but it won’t save lives if people don’t know when or where to get screened. The 2025 awareness campaign launched by the CCS, supported by the Public Health Agency of Canada, is a step in the right direction. It aims to reach women like me, who were and are younger than 50, who have never been screened, including trans, non-binary and gender diverse people.
Still, outreach needs to go further. Messaging must be personalized, culturally sensitive and designed to reach those without regular access to a family doctor and those living in remote or rural areas. After all, early detection through screening is one of our best defenses we have against breast cancer.
When cancer is found early, outcomes are significantly better. I found my lump early, but only because my cancer lived just beneath the surface of my skin and I could feel it with my fingers. I was also relentless about having it tested—despite initially being turned away from the cancer clinic my doctor booked me into, because they felt I was too young, because I did not have a familial history and because I did not meet any of the typical physical markers of someone with breast cancer. Even though the lump was right there. So, I stalked the clinic and insisted on being looked at again. It took six months to be taken seriously and to book a second appointment, where I demanded to have a mammogram and an ultrasound, but it paid off.
You can also talk about it
Spread the word. Tell your family and friends. Encourage everyone you know to get screened. Be a broken record. Early detection only works if screening is accessible and that includes sharing knowledge as much as infrastructure. Every woman and person with breast tissue needs to have access to clear information about when they can get screened, how to self-refer if needed and why it matters. Understanding your personal risk is also important. CBCN’s Risk Pathways factsheet offers a simple overview of common risk factors and can help you talk to your doctor about when screening is right for you. Here is a quick breakdown of the 2025 updated breast cancer screening guidelines, as documented by the Canadian Partnership Against Cancer, to share with everyone you know.
Starting at age 40, you are eligible for screening in British Columbia, Nova Scotia, Prince Edward Island, Newfoundland and Labrador, New Brunswick and the Yukon. Starting at age 45: Alberta and the Northwest Territories. Saskatchewan will move to age 40 in June 2026 and Manitoba will lower its age to 40 by December 2026. Quebec is currently reviewing its screening policy. Women can self-refer for a mammogram without a doctor’s referral by age 40 in many areas, however some provinces still require women under 50 to get a doctor’s referral or must self-refer, so checking the guidelines is crucial.
Adriana Ermter is a multi award-winning writer and editor. Her work can be read in IN Magazine, 29Secrets.com, RethinkBreastCancer.ca and AmongMen.com. The former Beauty Director for FASHION and Editor-in-Chief for Salon and Childview magazines lives in Toronto with her two very spoiled rescue cats, Murphy and Olive. You can follow Adriana on Instagram @AdrianaErmter
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