The future of mammography at the Bulkley Valley District Hospital is up in the air.
The essential women’s service could soon be transferred to the Mills Memorial Hospital in Terrace. This was discovered during a meeting between Margaret McDonald and Alice Chaplin — both retired radiographers — and a health service administrator at the Bulkley Valley District Hospital.
Chaplin explained they went into the hospital to have a fact-finding meeting. They wanted to find out the hospital’s stance in regards to mammography. As of right now, the Bulkley Valley District Hospital does conduct mammograms.
However, according to McDonald and Chaplin, there is a new standard for mammography that isn’t met at the hospital.
“The new standard for mammography is digital mammography and we have film-based mammography,” said Chaplin.
This means that when the x-rays are taken, it is captured by film. The x-rays then have to be developed and sent to a radiologist to be read.
“The new ones are digital completely. So when the x-rays are done, when the imagine is taken it is loaded on a computer, there is no in-between step. It goes directly from the sensors to the computer, at which point it then goes to the radiologist,” she said.
Chaplin explained this causes less risk because it is electronic, not manual.
“No one has to process it where your chemistry has to be optimum,” she said.
By 2018 this type of mammography will be fazed out all across British Columbia, every hospital will be digital. This leaves the hospital having to make a choice on what will be the future of the mammography service. One of the options, according to Dr. Joce Fourie, is transferring the service to the hospital in Terrace.
Dr. Fourie is the medical director of the Northwest based in Terrace, and medical lead for Northen Health Cancer Care.
Fourie explained there are two different types of mammography: screening and diagnostic.
“From a screening perspective, the intent is to serve the Bulkley Valley with a mobile screening mammogram unit like they do across the province, really,” he said.
This mobile service is already being used in communities like Nelson and Haida Gwaii.
As of right now, “the Mobile Mammography Service visits more than 120 rural communities across B.C., including more than 35 First Nations communities annually,” according to the BC Cancer Agency website.
“The intent would be to have that and to have enough frequency of screening mammography units to improve the conveniences for patients in the Bulkley Valley,” said Fourie.
With this new system, the images will be upload electronically and can be examined off-site in real time by radiologists, according to Fourie.
However, he does recognize the convenience issue surrounding the mobile service.
“People might be away in the summer, people work off-site; it could be difficult for them to reach one of those units, so the more frequency you have, the better,” he said.
If a woman does miss the mobile service they can go to any clinical units that provide the service in Terrace, Prince Rupert and Prince George.
Fourie explained one digital mammography machine can service all the women in Northern Health’s jurisdiction.
“From Haida Gwaii to McBride and Quesnel to Fort Nelson had only one machine. It’s capacity is enough to screen and do diagnostic procedures for all women in Northern Health. It’s a tremendous over capacity that we have at the moment and the only reason why we are placing units out there at 700 per cent the capacity we need is because of geography,” he said.
To purchase a new machine would be $1 million, but the money isn’t always the problem, according to Fourie.
“We work with partnerships, the machine installations are determined by the Screening Mammography Program of BC and they have a formula that they apply,” he said.
This formula determines which area needs the machine and which areas can receive the machine by services. In the assessment, the Smithers hospital was not one of the communities that needed the investment because of the other alternatives available.
Diagnostic mammograms take place after suspicious results from a screening mammogram.
Fourie and his team predicts that about 380 to 400 people will have to travel to Terrace to get additional diagnostic exams. This is where the idea of integrating and expanding the ultrasound and mammography department at the Terrace hospital comes into play.
“What you lose in feasibility you gain in quality, because of the integration of services,” he said.
Fourie explained a trial project for this type of integrated service has already been done for patients in Haida Gawii.
“We integrate their care in a single package so that we can optimize their time: get them here from a ferry, see them, diagnose them and get them on their way in a very time-compressed fashion,” he said.
If someone from Smithers was to come to Mills Memorial, according to Fourie they would be booked early in the morning because of their travel distance.
“If they needed an ultrasound as well, the ultrasound would be performed and because we have the person early in the day, we can do that,” he said
However, this idea sounds far fetched to both Chaplin and McDonald.
“There is no way they are going to have an ultrasound technologist sitting on hold in case you need an ultrasound after that,” said McDonald.
Both Chaplin and McDonald are concerned of how women who don’t drive will get to Terrace. As of right now, Northern Health does provide a bus service that takes patients from Smithers to Terrace on Thursday’s leaving Smithers at 8:30 a.m. and departing Terrace at 4:00 p.m. This is the only round trip provided by Northern Health. The schedule for the BC Transit service between Terrace and Hazelton has yet to be finalized, and it is not certain it will synchronize to be able to get from Terrace to Smithers any earlier.
There hasn’t been any final decision as yet in what they hospital will do. However, for McDonald and Chaplin, this issue is beyond just getting rid of mammography — it’s an issue that involves all women.
“It is really hard for us because I feel we have to stand up for the women in this place. It is a women’s issue and we are really concerned about the women we know, past, present, and future who really will not go,” said McDonald.