By Dr Ian Campbell
Chair of Waikato Breast Cancer Research Trust
Every working day more than one Waikato woman is diagnosed with breast cancer. Every year there are more than 3000 New Zealand women and 20-30 men diagnosed. Breast cancer is the most common cancer affecting women and each year more than 600 will lose their lives to this disease.
Waikato is a very active centre for breast cancer research. Waikato Hospital is a centre for many clinical trials coordinated via Breast Cancer Trials Australia & New Zealand. Through this cooperative group between our two countries, we collaborate with other international breast cancer research groups to bring international best practice to our care and treatment of Waikato women/patients.
Since 2000 the trust has enabled clinical trials introducing new surgical techniques, radiotherapy techniques and drug treatments. We have also researched for better quality of life, reducing side effects of treatments and improved communication. With patient consent, we also send off tumour blocks to overseas laboratories for research to help understand the biology of different types of breast cancer and how different treatments work.
We have been involved in trials evaluating a new marking technique using a radioactive seed to guide surgeons for excision of non palpable breast cancers. This technique has benefits over our previous standard marking technique. We have a local clinical trial introducing a novel surgery called lymph node grafting for the treatment of resistant lymphoedema, a swelling of the arm which is a side effect of breast cancer treatment. Our research team is collaborating through Breast Cancer Trials to evaluate a sophisticated laboratory technique for use in selecting women who have very low risk for recurrence tumours for whom radiotherapy may be safely avoided. We are also investigating a highly targeted new drug treatment for women with high-risk tumours in the hope that we can prevent these women from developing secondary or incurable breast cancer.
Research is the best weapon we have to fight breast cancer. By providing our patients with access to clinical trials, we can advance our knowledge of breast cancer, discover best-practice treatments, and provide all patients with the outcomes they desperately want. Clinical trials translate the discoveries of basic science, technology and pharmacology into real results for women. They are vital to help us determine whether new treatments are safe and effective.
All the major milestones in controlling breast cancer worldwide have been discovered through clinical trials, making them vital in increasing the chances of surviving breast cancer. Thanks to trials, we have developed effective prevention and treatment strategies and breast cancer screening programmes using mammograms. Clinical trials add to our body of knowledge about beating cancer, and the research that happens today will help to benefit future generations of women all over the world. The most common thing women say regarding why they take part in a trial is “I want to help others, including my children”.
Another major part of the trust’s work towards building our understanding of breast cancer comes through the Waikato Breast Cancer Register. The register is a confidential online database where we store information about Waikato breast cancer patients. More than 6443 cases of breast cancer are recorded, dating back to 1991. Each year, more than 300 cases are diagnosed and added.
We collect data on patient demographics and risk factors, as well as the type of cancer, surgeries and treatments. This gives us a detailed record of how breast cancer affects Waikato and New Zealand women and men, including outcomes.
Maintaining the register is a huge undertaking. Each week our two part-time staff must research, collate and enter new patients into the register, as well as obtain long-term annual follow-up information on every Waikato breast cancer patient.
The register allows us to monitor standards of care and track whether the most effective treatments and diagnostic processes are being used. For instance, the register has enabled us to research inequities in outcomes in Waikato, especially among Māori and Pacific women. Māori and Pacific women have almost double the death rate compared with NZ European women. However, it has also shown that in practice, women with screen-detected breast cancers do very well – regardless of ethnicity or socioeconomic status. This information highlights the importance of wahine having regular mammograms for better outcomes.
The WBCRT uses a yellow button to symbolise holding lives together through evidence-based breast cancer research. The button logo came from the wording, “Mothers are like buttons, they hold everything together”. Many women diagnosed with breast cancer are mothers. And our register research highlights the importance of mothers needing mammograms, just like children need their mothers!
We receive minimal government funding for our vital research and are completely reliant on grants, fundraising and donations.
I remain optimistic that one day there will be a cure for all breast cancers. Until then, we must never let it rest! We need your assistance to help save the lives of mothers, and also whaea, daughters, sisters and partners, workmates, friends and neighbours.
• Dr Campbell is an associate professor and surgeon.
• The Waikato Breast Cancer Research Trust uses a yellow button to symbolize holding lives together through evidence-based breast cancer research. Just as a shirt would fall apart without buttons, without the hope that our research gives, so to would the lives of thousands of women diagnosed with breast cancer. The yellow-on-black signifies light cutting through darkness.
