Lumping it

A one-size-fits-all approach to our breast-cancer screening programme is letting down high-risk women, say critics. 

- SARAH CATHERALL 

Just days before her 50th birthday early last month, Nichola Turenhout had her first round of chemotherapy. Two months earlier, on June 16, the Auckland journalist had a mastectomy to remove a tumour. When the cancer was taken out, it was 12.8cm in size - almost half the length of a ruler, and double the size of what an MRI scan had suggested. She also had two lymph nodes removed, as the cancer had spread there.

But until April this year, Turenhout had no idea she had cancer. Over the previous decade, since her 40th birthday, the founder had six mammograms. All were clear. A mammogram can pick up a cancer as small as a grain of rice Auckland-based NZ Writers College founder had six mammograms. All were clear. A mammogram can pick up a cancer as small as a grain of rice (about 7mm), but Turenhout’s growing lump was missed.

"I think it was many years old but it was never picked up despite so many annual mammograms and all the money I spent on screening," she says.

At her first screening a decade ago, Turenhout was told she had dense breasts - a type of breast tissue affecting an estimated 1 in 10 women, which elevates the risk of breast cancer and is more difficult to detect on a standard mammogram. In New Zealand, however, women getting publicly funded mammograms aren't told they have dense breasts - it's only in the private system that this information is shared.

Turenhout's breast cancer was believed to be missed for two reasons. Despite getting regular mammograms - some she self-funded - her dense breasts made her tumour more difficult to find, and it was a rarer form: lobular cancer, which is harder to detect on a standard mammogram.