Dr. Janice Nazareno

I’ll never forget caring for a young woman who was diagnosed with breast cancer just a week before her wedding.

Instead of figuring out table settings and planning her honeymoon, she was being overwhelmed by chemotherapy and fertility preservation.

Stories like her stay with me. As a mother of three daughters, seeing breast cancer affect younger women hits close to home. These are young mothers, young women building their careers and just starting to plan their futures. A diagnosis at this stage of life can bring so much more uncertainty with it, including work, family, fertility and what comes next.

I started working as a radiologist at Scarborough General in 2009, and 17 years later, I’m still here. My husband, who is also a doctor at SHN, grew up in Scarborough, and we’ve built our careers and raised our family here

My husband and I are both first-generation immigrants, so I have experienced personally some of the challenges and struggles that many of our patients face. I've worked at several hospitals across the GTA, but there's something special about working in Scarborough. Our patients come from so many different backgrounds and are incredibly grateful, hard-working, and appreciative of the care we provide.  

Over the years, breast imaging has become a bigger part of my radiology practice. When I first started at Scarborough General, there were only nine radiologists, and radiology was still largely male-dominated. I became more involved in breast imaging because I saw that women, particularly those with cultural considerations, often feel more comfortable with female physicians.

Today, we have a much larger group of female radiologists, which means we're better able to accommodate our patients' needs.

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What matters in a community as diverse as Scarborough. Some patients have cultural requirements around who can examine them, and some specifically request a female radiologist. We have to understand that everyone is different and approach each patient with that in mind.

We're also seeing more younger women coming through our breast imaging program. The screening age has been lowered to 40, bringing a whole decade of women into screening and there is also greater awareness around breast health in this age group due to increased online resources and social media. At the same time, we're seeing more breast cancer affect younger women.

Younger patients can be more challenging to screen because increased breast density can hid smaller lesions and makes images more difficult to interpret.  The sooner we can find cancer, the better. So having access to the right technology and expertise is incredibly important.  

But breast care is about much more than reading an image. It really takes a village. And that’s not unique to breast care; it’s true across all areas of radiology.

Sometimes I feel like my role is small. I’m looking at the images and making the diagnosis, but there is so much that happens downstream. As a radiologist, I don’t work alone. The communication between radiologists, surgeons, pathologists, nurses, navigators and care coordinators is critical. Every person plays an important role in making sure a patient receives the care they need.

The equipment matters, too. Better equipment helps us diagnose and problem-solve more effectively, and we're finding more cancers and more complex findings because of the technology we have. But to provide the best care, you need the right people. People are our best asset.

When I think about the future of healthcare in Scarborough, I want our patients to have access to the modern technology, abundant resources, and exceptional teamwork, because we deserve it, too.  

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