Henrietta, the Other Dr. Banting: Early Mammography Research at Toronto’s Women’s College Hospital (1967)
By Denisa Popa, University of Toronto
This is the first entry in a two-part series on the history of Women’s College Hospital.
One of the most documented figures in the history of Canadian medicine is Sir Frederick Banting, credited for his contribution to the co-discovery of insulin in 1921-22. This short post will explore the life of the “other” Dr. Banting – Lady (Dr.) Henrietta Banting – and her important (but often overlooked) contributions to cancer research, specifically her involvement in a 1967 study measuring the effectiveness of mammography as a diagnostic tool for the early detection of breast cancer (Dickin 1997; Forbes and Banting, 1967).
Dr. Henrietta Banting, Director of the Cancer Detection Clinic, 1960s, Courtesy of the Miss Margaret Robins Archives of Women’s College Hospital
The Other Dr. Banting
Henrietta Ball’s career began in 1932 when she graduated from Mount Allison University with a BA in Biology. After a few years, she attended the University of Toronto, earning her MA in 1938 while conducting research at the Banting Institute. She met Sir Frederick Banting in 1937 and married him two years later. Sadly, she lost him two years later after he died in a plane crash off the shores of Newfoundland. In 1945 she completed her medical studies at the University of Toronto (Dickin, 1997).
A scientist and physician, Dr. Banting served as the director of the Cancer Detection Clinic at Toronto’s Women’s College Hospital (WCH) from 1958 to 1971. Established in 1911, WCH itself holds a unique place in Canadian medical history as the first women’s hospital that was founded and staffed entirely by women (Kendrick and Slade, 1993).
Cancer Detection Clinic Staff (Banting pictured second from left), 1958-1971, Courtesy of the Miss Margaret Robins Archives of Women’s College Hospital
The Cancer Detection Clinic
Women’s College Hospital first opened the Cancer Detection Clinic in 1948 with the goal of screening healthy, asymptomatic women for the early detection of cancer (Messner, 1992). Women attending the clinic received a comprehensive physical examination, which included a chest X-ray, cervical smear, urinalysis, and later in 1963, routine mammography. (McConney, 1950; Kendrick and Slade, 1993). Indeed, WCH’s use of routine mammography in 1963 was decades before provincial screening programs became more widespread in Canada. British Colombia, for example, established the first one in 1988, with Ontario following in 1990 (Public Health Agency of Canada, 2008).
When it opened in 1948, the Cancer Detection Clinic could only screen 24 patients each month. The demand for the clinic’s services became so large that in 1966 it was relocated to a larger facility where it screened over 500 patients each month. Prior to the relocation, patients had to wait up to a year or more for an appointment. After two decades of operation, 31,814 patients were screened and 346 cases of early cancers were detected in asymptomatic women. These numbers reflect the clinic’s growing importance, and awareness and fears of cancer that Canadian women experienced in the last half of the 20th century. (Messner, 1992; Dickin, 1997; Banting, 1948-1968)
Dr. Florence McConney, the clinic’s first director, reflected on this widespread fear of cancer. In a 1952 article in the Ontario Medical Journal, she observed that “[b]ecause many of the articles and pictures about cancer in the lay magazines are of a frightening nature, many women come to us really afraid of having an examination” (McConney, 1952).
“An Assessment of Mammography”
In 1967, Banting co-authored a study with Dr. Elizabeth Forbes, WCH’s Chief of Radiology, on the effectiveness of mammography as a diagnostic tool in the detection of breast cancer. The study began in 1963 and lasted four years–the results eventually published in the Journal of the Canadian Association of Radiologists in 1967. Study participants, recruited in-part from the hospital’s Cancer Detection Clinic, underwent routine mammography in order to address the high rate of breast cancer previously recorded by the hospital’s physicians. As a result of the use of mammography during this study, WCH (through its Cancer Detection Clinic) became the first hospital to use mammography as a routine screening tool for breast cancer in Ontario. (Forbes and Banting, 1967; Kendrick and Slade, 1993)
Dr. Henrietta Banting (at microscope) with Dr. Alice Gray, 1960s, Courtesy of the Miss Margaret Robins Archives of Women’s College Hospital
As the two doctors observed, “[t]he high incidence of carcinoma of the breast seen and treated at our hospital and the lack of improvement in overall results over the years, made it necessary for us to attempt to assess the value of mammography in our hands.” (Forbes and Banting, 1967; 478)
The study evaluated the diagnostic accuracy of both mammograms and physical examinations conducted on 1,436 patients. The results concluded that a combined approach using both mammograms and physical exams was the most accurate in the early detection of breast cancer (Forbes and Banting, 1967).
Through the process of recruiting study participants from the Cancer Detection Clinic, Forbes and Banting turned the clinic into a site of medical research for breast cancer screening. In doing so, the physicians and the study participants entered the typically male-dominated domain of cancer research.
Forbes and Banting’s study represented “one of the first Canadian papers on mammography” (Canadian Family Physician, 1977; 31) and an early entry into a growing body of North American cancer research. This study was also conducted almost two decades before the second wave of the North American women’s health movement in the 1980s, when activists lobbied for increased breast cancer research (Baird, 2009).
The Cancer Detection Clinic and the 1967 mammography study, both headed by the “other” Dr. Banting, represent an important moment in the history of women’s medicine in Canada. The clinic became a site of medical research for breast cancer screening, led by two female physicians, at a time when women’s cancer research was often overlooked.
In my next post, I will continue to explore the hospital’s history, highlighting how the transnational and cross-border movement of people and ideas helped shape this institution in its early years.
References
Baird, K. (2009) “One in Eight: The Politics of Breast Cancer.” In K. Baird, D. Davis, & K.
Christensen (Eds), Beyond Reproduction: Women’s Health, Activism, and Public Policy (pp. 77- 92). Madison: Fairleigh Dickinson University Press.
Banting, Henrietta. Typescript: Twenty Year Review of Cancer Detection Clinic Women’s College Hospital 1948-1968. Folder: Twenty Year Review 1948-1968. Cancer Detection Clinic Fonds. The Miss Margaret Robins Archives of Women’s College Hospital, Toronto, Ontario, Canada.
Dickin, J. (1997) “‘By Title and by Virtue’: Lady Frederick and Dr Henrietta Ball Banting.” In E. Cameron and J. Dickin (Eds), Great Dames (pp. 245-263). Toronto: University of Toronto Press.
Forbes, E., & Banting, H. (1967). “An Assessment of Mammography.” Journal of the Canadian Association of Radiologists, 18(4), 478-479.
Kendrick, M., & Slade, K. (1993). Spirit of Life: The Story of Women’s College Hospital. Toronto: Women’s College Hospital.
McConney, F. (1952) “Cancer Detection Clinic: Women’s College Hospital.” Ontario Medical Journal, 117-118.
McConney, Florence. Typescript: History of The Cancer Detection Clinic Women’s College Hospital. 1950. Folder: CDC History, Cancer Detection Clinic Fonds. The Miss Margaret Robins Archives of Women’s College Hospital, Toronto, Ontario, Canada.
“Memorial Trust Fund for Henrietta Banting.” (1977). Canadian Family Physician, 23(143), 31.
Messner, Sandra. Typescript: History of The Cancer Detection Clinic. 1992. Cancer Detection Clinic Fonds. The Miss Margaret Robins Archives of Women’s College Hospital, Toronto, Ontario, Canada.
Organized Breast Cancer Screening Programs in Canada: Report on Program Performance in 2003 and 2004. (2008). Ottawa: Public Health Agency of Canada.
Reynolds, H. (2012). The Big Squeeze: A Social and Political History of the Controversial Mammogram. Ithaca: Cornell University Press.