Up to 300 women could have breast cancer and not know with the pandemic pushing back 50,000 mammograms. Emma Russell reports.
Cheryl Morrow remembers waking up in the middle of the night thinking about all the letters she would need to write her children before she died.
Birthday letters until they are at least aged 55, she thought. And then there are letters for their weddings and congratulation letters for when they welcome their first baby into the world.
"All these important milestones that I was potentially going to miss out on because I might not be alive to see them. It terrified me.
"My kids are the most important thing in the world to me. Not being there for them scared me the most".
On the day Auckland entered its fourth lockdown, August 17 last year, a letter was being written for Morrow, informing her she was due for a mammogram. She was celebrating her 49th birthday.
The Waikato mum-of-two wasn't worried because she hadn't experienced any symptoms and she was fit.
However, when she tried to book her mammogram she was told they weren't taking any bookings during lockdown.
"I told them they needed to book it because I'm the type of person that if I don't book, I'll put the letter in the cupboard and then it won't see the light of day and then I'll get a letter a year or six months later saying I'm overdue."
After insisting the mammogram was too important, Morrow had an appointment booked for six weeks time, when the country was in level 3.
Despite thinking it was very unlikely she would have breast cancer, she wanted to be sure for the sake of her kids. She lost her own dad to liver cancer 11 years prior and her mum was battling an aggressive form of endometrial cancer, which had spread to her spine.
In October, she drove 30 minutes from her Pukekawa home to the Pukekohe breast screening clinic, where she met a nurse whose kids went to playgroup with her kids.
"She was taking lots of photos but I didn't think anything of it."
The next day, her phone rang. It was a nurse from the clinic, saying the scan showed something in her left breast and they wanted to be sure it was nothing to worry about.
At the time, she had a shoulder injury so she wasn't able to self-examine her breast. It wasn't until she was at the clinic and the nurse helped her feel it, she realised there was a lump, which turned out to be 18mm.
"The doctor just said 'I don't like the look of this' but I didn't think much of it and was still optimistic. Then we saw the medical director who told me straight away I had cancer in my left breast. I said 'how do you know, we don't have the biopsy results back yet' and he said he'd been in the job 30 years and he could tell by the shape of the scan; it was cancer.
"I burst into tears, it was really upsetting because you never think it would be cancer."
Morrow remembers rushing to her car to call her sister in the UK and looking up at the sunny spring sky as she listened to her sibling sob on the phoneline.
"We didn't mention cancer to the kids, we just said there was a lump and it was going to be removed and everything was going to be okay," Morrow said.
At the same time, she was lying awake thinking about their lives without her.
"I just didn't want to worry them. I didn't want my daughter stressing or her saying to somebody, 'mum's got breast cancer' and then them saying, 'oh my gran had that and she died of cancer'."
Within two weeks, Morrow was getting her left breast removed. Then, for a week in January, she travelled an hour and a half every day to Auckland City Hospital for radiation.
Now, she's cancer-free but requires yearly mammograms as there's a chance it could come back.
If Morrow hadn't pushed for an appointment, she believes, she could have been facing a death sentence. She worried about other women who had been forced to wait months for their mammogram.
This month, Breast Cancer Foundation New Zealand is launching a campaign called #GiveUsOurMammograms, demanding action to prevent avoidable deaths.
Nearly 50,000 women are overdue for their mammograms because breast screening couldn't happen during Covid-19 lockdowns.
This means more than 300 women could die of a breast cancer they don't know they have, the foundation estimates, unless the Government is able to take urgent action. In October, it was 133 women.
Every day, nine women in Aotearoa are diagnosed with breast cancer. More than 60 per cent of them aren't getting their first surgery within a month of their diagnosis and, the foundation says, wait times were getting worse. Every year, we are losing 650 women to the disease.
The campaign is calling on the Government to commit $15 million to urgently clear the mammogram backlog and prevent women being diagnosed late.
"Mammograms are the best tool for an early diagnosis and it's crucial everyone can get their regular mammograms when they're due," the foundation's ambassador and broadcaster Stacey Morrison said.
Her mum died of breast cancer at 45. Morrison has just turned 45, which means she's now eligible for free screening.
After getting her first mammogram, she said: "It's a bit scary, but I promise you it's scarier not to do it."
The foundation's chief executive Ah-Leen Rayner said since the screening programme was developed, there had been a 30 per cent reduction in breast cancer fatality rates but now Covid had set New Zealand back 10 years.
"If Māori survival was to go back to where it was 10 years ago, wāhine would be twice as likely to die than they are today. That is absolutely tragic.
"New Zealand women are three times more likely to die if they find a lump than if their breast cancer was found on a mammogram, that's really important."
A mammogram will pick up lumps as small as 2mm. The smallest size detected from self checking was about 14m. The average size of a self-detected lump is 22mm.
Postcode lottery was a real problem, Rayner said.
"Some areas are doing really well and others are really struggling."
Some women are ringing up to book a mammogram and are being told there's a waiting list of six to eight months, Rayner said.
"Some have forced their way into getting a mammogram and luckily enough for them they've had cancer detected but if they had waited, it could have spread to lymph nodes which has a devastating effect for treatment and outcomes for patients."
She said they had been talking to the Government for six months but so far their calls had fallen on deaf ears.
Associate Health Minister Dr Ayesha Verrall said they knew there were delayed mammograms and planning was underway to clear the backlog.
This included modelling to understand if additional resources were required, she said.
Verrall said about 47,500 mammograms needed to be completed to reach the national target of 70 per cent of women aged 45-69 being screened every 24 months.
"People who have had a screening mammogram previously are only waiting on average one and a half more months for their next mammogram than they were pre-Covid.
"This was achieved despite crucial staff shortages, and apart from short periods in national lockdown, breast screening continued at a time when many other countries stopped screening for extended periods of time."
She said additional funding of $10 million for breast cancer screening was included in Budget 21 and the Ministry of Health was working hard with screening providers and other parts of the health system to act and plan to catch up on screening.
Meanwhile, people like Morrow could slip through the cracks.
"The Government are responsible for stopping people losing their mums, aunties, siblings, sisters and children being left without parents," she said.
"Some women have small children, I just can't imagine how those women would feel if they hadn't been so lucky to be picked up early like me."