A Wellington woman with a family history of breast cancer says she had a screening while overseas after struggling to get checked in New Zealand.
The national screening age is between 45 and 69 but is being gradually extended to 74.
Health New Zealand said mammograms aren’t recommended as a screening tool under 40, but women under 45 can be screened if they have a high-risk profile, listing risk factors including family history with breast cancer and other associated cancers.
Katy, who asked to be identified only by her first name, told 1News it was difficult for her to get a mammogram in New Zealand – even with a family history of breast cancer, among other risk factors.
The 36-year-old said she sought an early screening after learning through an online tool that her lifetime risk was as high as 40%.
She said she was willing to pay privately but discovered that she "couldn't actually find a way" to get a screening under the age of 40.
"I did feel a bit frustrated because I really wanted to be proactive and do everything I could to make sure I was catching something early."
Katy instead got a mammogram and ultrasound while overseas which showed abnormal results, enabling her to get further tests and a formal diagnosis in New Zealand.
Screening criteria review underway
Health Minister Simeon Brown said Katy's case was very concerning.
"The question here is whether these criteria are clear enough and I think the reality is that needs to be reviewed," he said.
Brown asked his officials to review the criteria and whether it was fit for purpose.
“Are they actually picking up those patients, those women who are at high risk of risk cancer adequately?”
The minister said he expected to receive advice back in the next few months.
A one-size-fits-all approach
Breast Cancer Foundation chief executive Ah-Leen Rayner said women under 45 currently aren’t accommodated by breast cancer screening in New Zealand.
"There are 400 diagnoses per year for this age group alone," she said.
“And what that means is that these women are often diagnosed later with advanced stage disease and it's often harder to treat.”
While a high-risk pathway was available, Rayner said Katy’s case was a prime example of the criteria being applied inconsistently.
"To go through the measures that Katy went through to get a mammogram and to subsequently be diagnosed with breast cancer is just astonishing, which means there's more need in terms of risk-based screening in New Zealand."
Manchester Breast Centre director and oncologist Dr Sacha Howell said a national screening age of 45 was a one-size-fits-all approach, and better tools are now available for identifying women most at risk.
He said some women with high-risk factors may start screening earlier.
"And if you look at the other end of the spectrum, we can identify women at a very low risk of breast cancer," Howell said. “And so those women, if we were doing truly risk adapted screening, would potentially even start later than they currently do in New Zealand."
Health New Zealand urged all women with a family history of breast cancer – including those under the age of 40 – to be vigilant and raise any concerns with their GP.
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