You are your own best advocate.
Get the screening you need.
Do you have dense breasts?
Your healthcare provider may not be up-to-date on the risks of dense breasts. You are. Here's how to have a conversation with your provider.
You know that women with dense breasts face a higher risk of cancer and that cancer can be missed on mammogram because both dense tissue and cancer appear white. You know that a mammogram is not enough for you. Additional screening with ultrasound or MRI can find cancers missed on mammogram. You will need a requisition for additional screening and you will have to advocate for yourself to get that requisition. In Ontario, referrals to hospitals may be rejected, but if you get the physical requisition in your hand, you can call a community clinic (neighbourhood imaging clinic) to book a screening ultrasound on your own.
In some provinces, (Manitoba, Nova Scotia) supplemental screening is not accessible. However, that does not mean you should not ask in MB or NS- we must continue asking.
We outline in detail what to discuss with your doctor on Get Informed under the section “What If I Have Dense Breasts?” and there are conversation tips can be found in our Advocacy ToolKit.
Are you in your 40s?
Your healthcare provider may not be aware that the decision to screen at 40 is a woman's decision based on her values and preferences. Yes, it is your choice.
No woman in Canada should be denied a requisition. If you live in a province where you cannot self-refer at 40, it is your decision to have a mammogram in your 40s. That's also what the breast screening guidelines state. Your choice. It is highly recommended by experts to do so since 17% of breast cancers happen in the 40s and these cancers are more fuelled by hormones and thus more aggressive.
If you live in a province where you still need a requisition at 40 (AB, SK, QC, MB, NWT) then please check out the conversation tips for speaking with your health care provider about a mammogram starting at 40 in our Advocacy Toolkit.
Are you in your 20s or 30s?
Since most jurisdictions in Canada only allow self-referral for breast screening starting at 40 or 45, what can you do to be proactive about your breast health in your 20s and 30s?
1. Know your risk factors. Discuss your risk with your family doctor between ages 25-30.
According to the Canadian Society of Breast Imaging, a woman’s risk for getting breast cancer should be assessed by her health care provider by age 25-30 to determine if early screening is appropriate. About 4% of invasive breast cancers were diagnosed in women in Canada under age 40 in 2019.
Do you have personal risk for breast cancer, such as family history of breast cancer? If you have a first degree relative who had breast cancer in the 40s, it may be recommended that you begin screening ten years earlier. If you have a family history of genetic mutations, or history of lymphoma, you may be eligible for a provincial high risk program in which screening would begin earlier. There are many different risk scenarios so please have a discussion with you provider since women with a higher risk may need to start screening earlier than 40. Consider completing the IBIS risk calculator with your physician and discuss if there is a need for a personalized screening plan.
2. Be breast aware: Regularly perform self-exams to become familiar with how your breasts normally look and feel. Check out www.knowyourlemons.com for examples of breast cancer symptoms and clear instructions on how to perform a breast self-exam. See your health care provider about any unusual changes to your breasts. Insist on imaging for any symptom of breast cancer.
3. Make healthy lifestyle choices: Maintain a healthy lifestyle by staying active and eating a balanced diet. Avoid alcohol and smoking, which are both carcinogenic. These steps can reduce your overall cancer risk. It is estimated that ~50% of breast cancers can be prevented.
4. Advocate for yourself: Self-advocacy is important in this age group. If your circumstances/history indicate you need screening before 40, advocate for yourself. If you have a symptom, you may hear you are too young for it to be breast cancer. Only imaging can determine if the symptom is of concern. Do not be dismissed. Seek care elsewhere if needed. No healthcare provider has X-ray vision. You are your own best advocate.
Conversation tips for a discussion with your healthcare provider.
You’re in your 40s and denied a mammogram.
You have dense breasts and are denied a screening ultrasound.
You can refer your doctor/nurse practitioner to the Health Professionals tab on densebreast-info.org
Print and take to your doctor these recommendations from Canada's breast cancer screening experts at the Canadian Association of Radiologists and the Canadian Society of Breast Imaging.
Current breast screening recommendations for average risk women from the Canadian Association of Radiologists and Canadian Society of Breast Imaging are summarized as follows:
1. Women aged 40-49 should screen ANNUALLY with mammography
2. Women aged 50-74 should screen every one to two years with mammography
3. Women OVER aged 74 should screen every one to two years with mammography for as long as they are in good general health with life expectancy of approximately 7 years or greater
4. Below age 40 screening is not recommended for average risk women, but risk should be assessed by age 25-30 in order to determine if early screening is appropriate.
Spread the word.
Tell other women about dense breasts. Tell other women about the importance of mammograms.
Ask friends, family and colleagues if they are looking after their breast health. Do they know their density? If not, tell them why it’s important to know it. Have they scheduled their routine mammogram? Remind them of the importance of early detection. Each one tell one.
Do you know women in their 40s? Please encourage them to start mammograms. Anyone in Canada can have a mammogram in their 40s. In 7 provinces, self-referral at 40 is available (BC NL NS PEI NB YT ON). Cancer in the 40s can be more aggressive. Details on the importance of starting mammograms at 40 on our our FAQ page.
Do you know women 74+, please encourage them to continue screening. In 8 provinces, women can self-refer past 74 (BC AB MB SK NL YT NWT NS). In the other 4, a requisition is needed. Read more at mybreastscreening.ca
Share your story on our website.
If your cancer diagnosis was delayed because you have dense breasts, or if you were diagnosed in your 40s, please share your story. We'd also love to hear about cancers being found early! Stories are empowering and impactful for others. Please email us: info@densebreastScanada.ca OR upload your story here.
Join our team.
We are looking for help to raise awareness and advocate for better screening in every province. We are also looking for volunteers with expertise in marketing, communication, government relations and social media.
Follow & Share
Please follow us on Facebook, Twitter and Instagram and share our posts. Visit our second website mybreastscreening.ca
Share with your healthcare provider: A list of studies on the importance of screening at 40. Please ask your healthcare provider to check out breast screening guidelines made by experts responsiblehealthcareguidelines.ca
Demand action.
Advocacy in action.
We have made great progress in Canada on breast density notification coast to coast. In NL, QC, BC, and SK, your density category is online in your health portal. Elsewhere, the category is mailed with the result letter after a screening mammogram.
We have also made great progress on screening, starting at 40. Seven provinces/territories have self-referral at 40 already (BC, ON, NB, NL, NS, NB, YT). SK is age 43 and will be 40 in June 2026. MB, AB and NWT begin at 45. MB lowers the age to 40 in December 2026, and AB will lower it in April 2027.
How does your province rate on the 7 optimal breast screening practices?Check out our latest report, Comparing breast screening practices across the country.
Letters to politicians.
Please see the footer for the letter for your province and please take a minute to send it in. Please consider sharing the letter with your contacts. The more letters that get sent in, the more impactful. Your Health Minister's address is below.
Advocacy continues to ensure that women in Canada with dense breasts can access supplemental screening and women in all provinces can self-refer for a mammogram starting at age 40.
Draft Version of Canadian Breast Screening Guidelines 2024.
Our advocacy helped lead to the suspension of the Canadian Task Force on Preventive Health Care. The new National Advisory Committee on Preventive Health Services is expected to prioritize updating the breast screening guidelines.
British Columbia: The Honourable Josie Osborne HLTH.Minister@gov.bc.ca
Alberta: The Honourable Adriana LaGrange
Health.minister@gov.ab.ca
Saskatchewan: The Honourable Jeremy Cockrill
He.minister@gov.sk.ca
Manitoba: The Honourable Uzoma Asagwara
minhsltc@manitoba.ca
Ontario: The Honourable Sylvia Jones
sylvia.jones@ontario.ca
Québec:
ministre@msss.gouv.qc.ca
Nova Scotia: The Honourable Michelle Thompson
Health.minister@novascotia.ca
New Brunswick: The Honourable John Dornan
Prince Edward Island: The Honourable Cory Deagle
cdeagleministerhw@gov.pe.ca
Newfoundland: The Honourable Lela Evans
hcsminister@gov.nl.ca
FEDERAL HEALTH MINISTER:
The Honourable Marjorie Michel
hcminister.ministresc@hc-sc.gc.ca
Advocacy Milestones and Impactful Changes
Since its founding in 2016, Dense Breasts Canada (DBC) has emerged as a leading advocate for improved breast cancer screening policies and public awareness across the country. Through tireless efforts, DBC has made significant strides in achieving policy changes that prioritize early detection and equitable access to screening for all women.
You can read about the latest policy changes below, as well as in our report:
Advancing Breast Cancer Screening in Canada: A Summary of Policy Wins and Progress
Breast Density Notification
Screening Age Lowered to 40
When DBC began, only four provinces/ territories (BC, NS, PEI, YT) were offering self-referral mammograms for women starting at age 40. DBC successfully advocated alongside medical professionals and patient advocates and in 2024/25, three additional jurisdictions (ON, NB, NL) lowered the screening age from 50 to 40. In Jan 2026, SK lowered the age to 43 and MB lowered the age to 45. SK will be at 40 in June 2026 and MB in Dec 2026. AB will lower the age to 40 April 2027. We are now only waiting on NWT and QC.
Supplemental Screening for Women with Dense Breasts
Before DBC launched, supplemental screening for women with dense breasts was not widely available. Through DBC’s advocacy, women with dense breasts in BC, AB, NWT, SK, and ON now have access to additional screening. A list of clinics offering supplemental screening is available on our blog page.
Challenging the Canadian Task Force on Preventive Health Care Guidelines
DBC has led efforts to expose flaws in how the Canadian Task Force on Preventive Health Care develops national guidelines. Through testimony to parliamentary committees and meetings with PHAC, DBC raised key concerns about governance, oversight, and the need for up-to-date evidence and expert input in Canada’s breast screening guidelines. This advocacy resulted in a review of the guideline development process and a suspension of the work of the Task Force. The Task Force has been replaced by the National Advisory Committee on Preventive Health Care, as of May 2026.
Raising Awareness
In addition to policy changes, DBC has made significant strides in raising public awareness about the importance of breast cancer screening. Through public education campaigns, social media outreach, and collaborations with medical experts, DBC has empowered women with the knowledge they need to take control of their health.
Public Support and Grassroots Mobilization
DBC has galvanized public support for better screening policies. Through its messaging and community engagement, DBC has amplified the voices of women across Canada who are advocating for better breast screening.