2020 marks the 20-year anniversary of research carried out by the Waikato Breast Cancer Research Trust (WBCRT).

This local charitable trust was established in 2000 by a group of Waikato Hospital breast cancer specialist doctors and nurses. 

Over the past 20 years, the WBCRT has enabled over 45 clinical trials. Every advance made in treating breast cancer, worldwide and in the Waikato, has been the result of research.

These advancements include better drug treatments; both chemotherapy and hormonal therapies; improvements in radiotherapy, breast conserving surgery instead of mastectomy, the development of sentinel node surgical techniques instead of axillary dissection, and reducing treatment side effects and improving quality of life.

There are many different types of breast cancer and clinical trials research can offer individual women the best treatment for their type of cancer to ensure best outcomes.

Clinical trials are vital to help us determine whether new treatments are safe and effective. 

“Research ensures evidence based best practice and Waikato researchers want the best for those in our region diagnosed with breast cancer,” says Professor Ian Campbell, Trust founder and breast surgeon.

As we progress beyond 2020, the WBCRT is enabling clinical trials which are individualising treatments more to the specific features of each different type of breast cancer.

For example, drug treatments are becoming more targeted to specific growth factors of a tumour.

As technology develops there are specialised laboratory tests which can examine multiple aspects of a tumour. 

The results of these tests will help guide oncology doctors to select future patients who will, or won’t, benefit from treatments such as chemotherapy and radiotherapy.

Another area of research has been the use of decision aids to help patients make decisions about more complex treatment options.

Research achievements;

Reducing surgery to the armpit

Whether or not cancer has spread to the armpit (axillary) lymph nodes remains the most important indicator of outcome for women diagnosed with breast cancer, and helps predict the need for further treatment (e.g. chemo or radiotherapy). Traditionally, axillary node status has been determined by removal of all of the nodes (called axillary clearance or axillary node dissection). 

This operation may lead to arm swelling (lymphoedema), pain, some abnormal skin sensation, and shoulder stiffness.

Over the past 20 years the WBCRT has enabled the introduction of a reduced surgery to the armpit called “sentinel node biopsy”. Sentinel node biopsy involves surgical removal of the lymph nodes most closely related to the breast cancer (usually 2-3 lymph nodes).

Since 2001, Waikato breast surgeons and researchers have participated in a learning phase of sentinel node biopsy, followed by four international clinical trials introducing sentinel node biopsy surgery for different types of breast cancer.

The sentinel node biopsy trials have been part of the journey of reducing the amount of breast
cancer surgery.

In the 1970s it was believed that all women with breast cancer needed mastectomy, and nowadays most women don’t need mastectomy, and breast conserving surgery is performed in a majority of cases.

Prior to the early 2000s all women underwent axillary clearance and nowadays more women undergo sentinel node biopsy.

A new surgical technique for the treatment of breast cancer related lymphoedema seeks participants

Whilst sentinel node biopsy is able to be safely carried out in more and more women, there are still women for whom axillary node dissection is performed as part of breast cancer surgery.

This extensive surgery is recommended to remove lymph nodes with, or is known, to contain cancer spread. Lymphoedema is a condition experienced by 10-20% of women who undergo axillary lymph node dissection.  It can be a disabling condition causing discomfort and impacting upon the function and cosmetic appearance of the swollen arm.

Breast cancer survivors with arm lymphoedema have been found to experience poorer quality of life and more psychological distress than those without lymphoedema.

The current standard of care for lymphoedema is conservative management which includes self-administered massage, therapeutic exercise, and use of a compression garment. 

When conservative management does not help enough, surgery can be considered.  There is some evidence to suggest that transferring lymph nodes from elsewhere in the body to the affected limb can help to reduce the size of the affected arm.

A new, surgical technique, called lymph node grafting, was developed and tested in a pilot study in the Waikato. The pilot study demonstrated promising results for lymph node grafting as a treatment for moderately severe treatment-resistant lymphedema.

Following the pilot study researchers needed further evidence to be certain that this technique is safe and effective, as well as standardise and develop the lymph node grafting technique further and a larger clinical trial is now taking place.

The clinical trial is determining whether lymph node grafting produces a greater reduction in lymphoedema volume and improved quality of life, compared with standard treatment.

Waikato plastic surgeon Winston McEwan, who has developed the lymph node grafting technique, is heading this trial. Surgeries and trial visits are carried out at either Alison Surgical Centre, Braemar Hospital, Tu Tonu Rehabilitation Centre, and/or Waikato Hospital (all Hamilton based) by Winston McEwan or Associate Professor Ian Campbell.

Waikato researchers continue to seek participants with breast cancer related lymphoedema for the  clinical trial and for more information, please contact; Heather Flay, Research Nurse, on telephone 
07 8398726 Ext 97960 or email Heather.Flay@waikatodhb.health.nz

Supporting women participating in clinical trials

Dedicated Waikato breast specialist staff meet women at a very vulnerable time in their lives.

Whilst dealing with a diagnosis of breast cancer there are difficult decisions for them to make about their treatment options. What treatments available to them is directly related to the evidence provided in clinical trials. This is why breast cancer clinical trials are so important, they provide every patient with the treatment choice that will give them the best chance of long-term cure. Without the women who agree to be a part of a clinical trial, better outcomes for future generations would not happen.

When asked why breast cancer research is so important to her, Jo, a participant on one of the sentinel node biopsy trials says, “When you get cancer you suddenly discover so many women around you have been where you are about to go. My treatment and experience was all the more successful because of the research done by, and assisted by other women in my situation. So every bit you can do helps. Collectively it can be a pretty powerful thing. I like the aspect of being a part of something bigger”.

For the last twenty years, Waikato Breast Cancer Research Trust researchers have been inspired by the courage and determination of many women who have enabled us to gain knowledge and are part of the journey of saving lives from breast cancer.

Are you a business looking for a Waikato charitable trust to support?

Consider making a difference and supporting women like Jo. In the Waikato, more than one woman every working day is diagnosed with breast cancer. That’s upwards of over 400 Waikato women a year (plus 2-3 men). These women are your grandmothers, whaea, mothers, aunts, sisters, wives, partners, workmates, friends and neighbours.

The Waikato Breast Cancer Research Trust needs your support to enable clinical trials and research projects from the Waikato/Midlands Breast Cancer Patient Register, so that more women have a chance of cure. The Trust is not government funded and relies on the Waikato community for funding.

See www.wbcrt.org.nz to see how you can help raise much needed funds for our Waikato breast cancer research programme.

Pink Walk & Button Run Thursday 29th October 5.30 pm Hamilton Lake

Get your workmates together (and your boss) and enter a team, dress up in pink for breast cancer awareness, and yellow for breast cancer research, and see if your business or organisation can win an incredible morning or afternoon tea grazing table donated by The Little Lunch Company. There is also a $300 Midas Jewellers Voucher up for grabs for everyone that registers online, a $200 Lawrenson Group voucher for the BIGGEST team registered plus spot prizes for the best dressed. Join us at the Pink Walk and Button Run for breast cancer to be held Thursday 29th October at Hamilton Lake.

The Pink Walk is a 3.8 km fun walk around Hamilton Lake and the Button Run is approx. a 5 km fun run around the lake and Innes Common. This Pink Walk was first organised in 2006 by a group of health promoters and breast cancer survivors who wanted to raise breast cancer awareness in the
Waikato community.

The WBCRT have been recipients of funds raised each year. Braemar Hospital have always had a large contingent of walkers/runners enter and in 2011 became Gold Sponsor of the event. Sponsorship ensures that all funds raised go to, and are invested in breast cancer research.

So dress up and come along on the 29th, join some of the players from the Splice Construction Waikato BOP Magic netball and players from the Waikato Rugby Union.  Go to https://pinkwalk.co.nz/ to ENTER NOW with your family or friends, a work team of other group!

October is breast cancer awareness month

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 Māori women who are at even higher risk of developing breast cancer than non-Māori, and have over double the death rate compared to 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 with 94% breast cancer 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 on line 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:

You can examine your breast by looking at yourself in the mirror with your hands on your head.

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

Or 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 see something different, see your GP for a check-up 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.

Healthy lifestyle and reducing breast cancer risk:

Physical activity (e.g. moderate exercise up to 3-5 hours per week), maintaining a healthy weight and eating a healthy diet, are all factors that help with reducing breast cancer risk, and reducing risk of recurrence for those who have had a breast cancer diagnosis.

There are many other benefits to healthy lifestyle including improved general health, increased vitality, and enhanced wellbeing.