When Gina Nufrio found out she had cancer for the third time in just 10 years\u2013and after recently completing treatment for ovarian cancer, no less\u2013she felt, in her words, \u201cdown.\u201d<\/p>\n
For Nufrio, a Caledon resident who is eligible for regular MRI breast cancer screenings due to being at high-risk for the disease, the sadness and disappointment weren\u2019t necessarily short-lived. Still, she met her new diagnosis with the same attitude that\u2019s carried her through previous brushes with cancer: determination.\u00a0<\/p>\n
\u201cI keep myself in good spirits,\u201d she tells INsauga.com.\u00a0<\/p>\n
\u201cLife goes on.\u201d\u00a0<\/p>\n
Nufrio, who has a relatively rare genetic mutation that makes her more susceptible to several tumours (namely breast and ovarian cancer), found out about the suspicious mass during an MRI last December.\u00a0<\/p>\n
\u201cI had a mammogram and ultrasound and they did an MRI at the same time, which was new for me. I was told the MRI found my breast cancer.\u201d\u00a0<\/p>\n
After the MRI detected the suspicious mass, Nufrio underwent an MRI-guided biopsy, a procedure that was introduced at Brampton Civic Hospital in September 2024.\u00a0<\/p>\n
\u201cIt is new,\u201d Dr. Andrew Peppin, a radiologist with the William Osler Health System, a health care organization that operates Brampton Civic and Etobicoke General Hospital, tells INsauga.com.\u00a0<\/p>\n
\u201cAn MRI-guided breast biopsy is the most complex breast biopsy done. Usually, the bread and butter is using ultrasound or a mammogram to guide the needle towards the target. With MRI, it\u2019s a different situation because it\u2019s done when the patient is in a powerful magnet.\u201d\u00a0<\/p>\n
Peppin said the procedure can be complex and requires specialized expertise and equipment. The MRI-guided biopsy, which involves removing some of the potentially cancerous tissue from the breast to confirm or rule out cancer, is only recommended for patients whose tumours can only be detected by MRI.\u00a0<\/p>\n
\u201cIt\u2019s rare, we probably do two or three a month,\u201d Peppin says, adding that before Brampton Civic offered the procedure, patients had to be referred to Oakville Trafalgar Hospital.\u00a0<\/p>\n
\u201cThis is a very involved procedure; you don\u2019t want to do it unless there\u2019s no other way. Most patients can be managed with an ultrasound and a mammogram, which are very accurate. A certain subtype of cancer can only be seen on MRI, so the only way to sample that tissue is with an MRI. That subset of cancer patients is fairly small.\u201d<\/p>\n
Despite the procedure being recommended only for a small number of patients, Peppin said that bringing the technology and expertise to Brampton allows patients to receive all their tests in one place.\u00a0<\/p>\n
\u201cIt was a gap in our comprehensive care. For us to obtain this helps us close that gap,\u201d he says.<\/p>\n
Peppin says Fareeha Sajjad, the corporate modality supervisor \u2013 MRI at William Osler, was instrumental in bringing the technology to the Brampton hospital because she had worked with it before and was able to connect with vendors who could supply the parts and equipment needed to carry out the sensitive and precise procedures.\u00a0<\/p>\n
\u201cIt\u2019s a testament to her dedication that we are able to bring this important service to Osler,\u201d Peppin says, adding that physicians who carry out the biopsies receive special training.\u00a0<\/p>\n
While Peppin says the procedure can be uncomfortable because of the positioning, Nufrio said her experience was significantly better than her first breast biopsy several years ago.\u00a0<\/p>\n
\u201cI\u2019ll be honest, I had [a biopsy] done 10 years ago on my other breast cancer; this was a little painful, but I preferred this one. I coped with it; it wasn\u2019t bad. It\u2019s a little uncomfortable how you\u2019re lying down, but I adjusted with it,\u201d she said.<\/p>\n
After the biopsy, which she said took about 30 minutes from start to finish, things moved quickly.\u00a0<\/p>\n
\u201cFor me, I\u2019m lucky, everything moved quickly. I can\u2019t complain,\u201d she says, saying she appreciated the compassionate and prompt treatment she received at both Brampton Civic and Etobicoke General<\/p>\n
\u201cWith my situation, every time they find something, they move quickly. I\u2019ve had a good experience everywhere,\u201d she says.\u00a0\u00a0<\/p>\n
Peppin says that while MRI screenings (and biopsies) are rarer, they allow hard-to-see tumours to be tested quickly, potentially increasing the chances of successful treatment.\u00a0<\/p>\n
\u201cIf [these patients] didn\u2019t have the MRI, everything would look normal and they might present later with a more advanced cancer. It enables you to find cancers much earlier. These cancers, we\u2019re catching them early and historically, prior to MRI being available, their cancer would develop and grow until it was visible on a mammogram,\u201d he says.\u00a0<\/p>\n
\u201cThe main group is higher-risk women, but sometimes we also use it to investigate an abnormal mammogram to find out more. Another group of patients are people with invasive lobular cancer, which means there\u2019s a higher chance of having cancer in the opposite breast, so we do an MRI to look at the other side to see if that\u2019s okay. If we see something, they can get a biopsy as well.\u201d<\/p>\n
For Nufrio, the screening test and subsequent biopsy ensured she started treatment earlier. She underwent surgery in September and has since started a new round of chemotherapy and says that anyone nervous about the procedure should go through with it with the knowledge that, while anxiety-provoking, it could be life-saving.\u00a0<\/p>\n
\u201cI would tell them to go for the biopsy, it saved my life. It could save their life also. Don\u2019t be too nervous, think about something nice. Always smile\u2013it\u2019s hard, but try to smile. That\u2019s the way I\u2019m coping,\u201d she says.<\/p>\n
Nufrio also says the doctors and nurses helped alleviate her anxiety during and after the screenings and biopsy.\u00a0<\/p>\n
\u201cThey treated me like I was the queen. After the biopsy, I had to go for a mammogram upstairs and the nurse was so nice. She took us to the place, went out of her way to walk with us to the floor where the mammogram was. They\u2019re really kind.\u201d\u00a0<\/p>\n
While Peppin says the number of patients requiring MRI-guided breast biopsies is low, he expects demand to grow as more women seek out screening, especially since women 40 and older at average risk of the disease are now able to self-refer for conventional mammograms.\u00a0<\/p>\n
\u201cRight now we\u2019re able to manage local demand, but I think, especially now that we\u2019ve begun screening women between 40-49 routinely, that will lead to more MRI-guided breast biopsy requests, so we expect volumes to grow, but we\u2019re well-positioned to manage that in the short term,\u201d he says.<\/p>\n
Ultimately, the procedure helps ensure more cancers are caught earlier.\u00a0<\/p>\n
\u201cThere\u2019s a correlation between early detection and survival, so this definitely captures patients at an earlier stage,\u201d he says.<\/p>\n
Peppin also says having the technology to perform the biopsy in-house provides patients with both convenience and comfort during a frightening time.\u00a0<\/p>\n
\u201cA committee of radiologists will decide if [MRI-guided breast biopsy] is appropriate and we can decide this in-house; we don\u2019t need outside help to manage our patients. They can go somewhere they\u2019re familiar with and there\u2019s no travel time. This makes it easier to help patients get care that\u2019s appropriate as close to home as possible,\u201d he says.\u00a0<\/p>\n
As for Nufrio, her best advice for patients facing cancer is to trust their medical team and try to maintain as normal a routine as possible. She also says she still goes on daily walks and spends time with her children and grandchildren.\u00a0<\/p>\n
\u201cI know we all have our own way to handle it. Life goes on, and I still do everything I was doing before. I\u2019m still cooking, still cleaning when I can. I do my puzzles, read some books, go outside all the time, look after my flowers, talk to my flowers, and talk to myself sometimes because it helps. I do have my days, but we\u2019re all different,\u201d she says.<\/p>\n
For her, staying positive is important.\u00a0<\/p>\n
\u201cNever give up hope. Take it every day, don\u2019t think about what will happen tomorrow, wake up in the morning and think \u2018what will we do today?\u2019 Never give up and keep it going. When the battery goes down, I charge it and get back at it. You don\u2019t stop your life.\u201d<\/p>\n
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