From birth and throughout life, many of life’s most defining moments take place in a hospital.
For breast health patients, these can be happy moments of a clear mammogram, the anxiety of waiting for test results from a spot noticed in a breast, or the fear from hearing a breast cancer diagnosis.
Only breast cancer centre to be internationally accredited (National Accreditation Program for Breast Centers)
Starting this year, first in Canada to screen using both AI and contrast mammography*
Early adopter of image-guided seed localization before surgery*
Among the largest breast surgical volume in the GTA
One of Toronto’s largest breast MRI programs*
First in Ontario to adopt tomosynthesis (3D mammography)*
“I’ve seen first-hand what donor support can do at North York General. The impact our donors have had on our Karen, Heather & Lynn Steinberg Breast Centre over the past two decades has been transformative. We wouldn’t be where we are today without them. Today we have a new opportunity to expand the care experience with an additional mammography system that will help us treat thousands more patients with greater speed and accuracy than ever before. This will include state-of-the-art technology such as artificial intelligence (AI) to assist radiologists in breast cancer detection, and contrast-enhanced mammography. But we can only do it with your support.”
Dr. Ryan Margau
Chief, Medical Imaging, North York General Hospital
A key component within NYGH’s breast services are our three mammography systems — two located within our general site at 4001 Leslie Street and one at our Outpatient & Community Services Centre satellite site at 2 Champagne Drive. However, with only three machines, the wait time to receive a mammogram at NYGH is 56 days versus the provincial average of 29.6 days, due to a variety of factors including backlog from the pandemic years, increased awareness for breast screening in the community, and the desire to receive care at the hospital – all of which have driven up patient volumes.
For comparison, in 2019, the hospital treated 1,155 breast cancer patients, and in 2023, we treated 3,076 — a 166% increase.
Recent changes in Ontario’s screening guidelines have lowered the minimum age for regular mammograms from 50 to 40. This expansion, which took effect this fall, projects an additional 130,000 mammograms annually across the province. A critical incentive for this change is that 100% of women with breast cancer discovered at Stage 1 see at least a 5-year survival rate — a statistic that drops to only 30% for those who are diagnosed at Stage 4.
In terms of mammography, members of our community have two options for receiving imaging: a community clinic or a hospital. However, many patients may prefer seeking care at a hospital like North York General for a few key reasons. First, if a mammogram conducted at a community clinic reveals an abnormality, the patient is often referred to a hospital, where the mammogram must be repeated. Starting care at a hospital can reduce patient discomfort and stress by avoiding the need for duplicate imaging. Additionally, since mammography equipment is not government-funded and community clinics are not supported by philanthropy, these clinics often have older, less precise machines, which can impact the clarity and effectiveness of the imaging.
In order to be ready for the anticipated surge in patients later this year, while also managing our current flow of patients, a fourth mammography system, housed at the NYGH Outpatient and Community Services Centre on Champagne Drive, will allow our teams to perform an additional 11,000 screening and diagnostic exams each year.
Our current fleet of mammography systems recently underwent a technology upgrade to include Contrast Enhanced Mammography (CEM) and the introduction of AI. The new fourth system we hope to acquire will also have these capabilities, making us the first hospital in Canada to use this mix of innovative technology to detect breast cancer sooner.
CEM is an advanced breast imaging technique that uses a contrast agent to significantly improve the detection and characterization of breast cancer. When originally introduced in 2011, CEM consistently demonstrated better imaging results compared with standard mammography, especially when dealing with dense breast tissue. This is especially important at NYGH as racialized women—who are more likely to have dense breast tissue, a known risk factor for breast cancer—make up a significant portion of our community.
Often those with dense breast tissue would require an MRI in addition to their mammogram, however, wait times can be lengthy to receive an MRI. CEM offers sensitivity and specificity for breast cancer detection comparable to breast MRI; it can be used as an adjunct/alternate for breast cancer staging, and it is more cost-effective than MRI for intermediate-risk screening and the evaluation of dense breasts.
AI poses a unique opportunity for care teams, as the technology can continuously use data points from thousands of patients (anonymously) to help predict the pathways of future patients. AI detection technology assists radiologists to interpret mammograms by using a deep-learning neural network to analyze tomosynthesis images and identify lesions which appear to be potentially cancerous.
The algorithm searches for the common visual appearances of cancers: calcifications, masses, densities, and distortions. This will help our care teams plan ahead and potentially intervene sooner as images are assigned a case score indicating severity or urgency which can help prioritize review. North York General is a beta site for AI testing in Canada as Health Canada determines its approval and as such will help lead the future of breast health care for individuals across the country.
In terms of what success looks like in its implementation, it is the intention that AI will reduce the number of false positives reported from mammograms, which would decrease the number of recalls (or patients being required to come back for additional screening).
Through the support of donors, NYGH will acquire a fourth mammography system this year so that it can be put to good use right away for our community. All donations towards this new technology will go a long way for the thousands of patients who turn to us in their time of need. Cancer is a life-defining moment and through your support, NYGH can be there to support everyone going through this journey.
Director, Campaigns & Governance
North York General Foundation
laura.cuthbertson@nygh.on.ca
416-756-6722