Breast cancer awareness month is a time to raise awareness of breast health. If you are a woman and you are getting older, you have the two main risk factors for breast cancer.
One of the best things we can do to improve outcomes from breast cancer is early detection. This is important for all women, but especially so for our Māori women who are at higher risk of developing breast cancer than non-Māori, and have more than double the death rate compared with NZ European women. Research work supported by the Waikato Breast Cancer Research Trust has shown that Māori women with cancers detected through screening do just as well as non-Māori. Breast cancer cure in these women is high – 94 percent survival at 10 years.
Early detection saves lives:
Regular mammograms
• A screening mammogram is the best method for the early detection of breast cancer in women with no symptoms.
• We recommend women start having annual screening mammograms between 40-49 and then once every two years from 50 years (and up to age 80 – as long as women remain in good health).
BreastScreenAotearoa is New Zealand’s free breast cancer screening programme. It checks women for signs of early breast cancer using mammograms. You can have a free mammogram every two years through BreastScreen Aotearoa if you are between 45-69 years. Please phone 0800 270 200 to enrol in this programme. You can also enrol online at www.nsu.govt.nz.
Mammograms:
• Can show changes in the breast before anything can be seen or felt. In most cases the changes will not be cancer.
• Can detect breast cancer early, which means a very good chance of cure.
• Can detect about 75 percent of unsuspected cancer in women under 50 and 85 percent in women over 50.
• Cannot prevent you getting breast cancer and cannot always prevent death from breast cancer.
• Are safe because only very small amounts of radiation are used in two-yearly screening.
Be breast aware:
Changes in the breast to look out for and report to your doctor;
• A new lump or thickening.
• Skin dimpling or puckering.
• Any change in one nipple, such as discharge that occurs without squeezing or a turned-in nipple.
• A rash or reddening or scalyness of the nipple.
While most lumps and other symptoms are not due to cancer, proper assessment is needed to determine this. If you have a breast symptom, see your GP and get referred for appropriate further followup.
More and more women than ever before are surviving a diagnosis of breast cancer thanks to early detection and more effective, safe and tailored treatments developed through research.
New treatments being introduced to Waikato breast cancer patients through research:
Over the past year 20 years, researchers at Waikato Hospital and St Anne Breast Care have been centres for more than 40 different clinical trials and studies introducing new treatments for the different types of breast cancer, and research to improve quality of life and reduce side effects. Many of these treatments are standard of care now. They include:
• Use of aromatase inhibitors to treat hormone receptor positive breast cancer in postmenopausal women.
• Use of ovarian ablation in addition to other agents to treat hormone receptor positive breast cancer in premenopausal women.
• Better chemotherapy regimens.
• Molecular assays to better select women who most need chemotherapy and avoid it in those who do not.
• The role of post mastectomy radiotherapy.
• Use of bisphosphonates to improve bone health and breast cancer outcomes.
• Drugs to assist breast cancer prevention in high risk women.
The following are some examples of research currently being carried out:
• In the early 2000s Waikato researchers introduced sentinel node biopsy, a lesser surgery to the armpit performed in conjunction with surgery to remove the tumour in the breast. Sentinel nodes are the first lymph node/s most closely related to a breast cancer. At the Waikato Breast Care and St Anne Breast Care we continue to study extension of this technique to women with more advanced breast cancers, and in relation to need for additional axillary treatment (the POSNOC trial).
• Both centres are participating in a clinical trial (coordinated internationally through Breast Cancer Trials ANZ) evaluating a sophisticated laboratory test (called a genomic assay) to help select women who have very low risk for recurrence tumours for whom radiotherapy may be safely avoided.
• We are part of a world-wide clinical trial investigating a targeted new drug (a CDK 4 & 6 inhibitor) for women with high risk breast cancers. The aim of this trial is to investigate whether the new drug (Abemaciclib), is better at reducing the risk of cancer returning when compared with standard treatment.
• We are studying lymph node grafting as a possible new surgical treatment for lymphoedema (arm swelling sometimes caused by breast cancer treatment).