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BREAST CANCER PREVENTION

Currently, there is no way to definitively prevent breast cancer from occurring. However, there are ways to manage some breast cancer risk factors to reduce the likelihood of future breast cancer.

How to Reduce Your Breast Cancer Risk

Over the course of your lifetime there are a number of risk factors you may be exposed to. Some cannot be changed, such as being a woman or having a strong family history, however other factors can be changed through healthy lifestyle decisions and risk-reducing strategies.

By better understanding your personal risk of breast cancer and getting regular screening, you can help improve your chance of better outcomes. You can use the iPrevent online tool to help better understand your breast cancer risk.

Clinical Trials Focused on Breast Cancer Prevention

A prevention-based breast cancer clinical trial is a research study designed to evaluate strategies, interventions, or treatments aimed at reducing the risk of developing breast cancer, particularly in individuals identified as having an increased risk. Breast Cancer Trials has conducted many clinical trials in the prevention setting including the BRCA-P clinical trial and IBIS-II clinical trial. Learn more about our successful trials and research. Donate to life-saving breast cancer clinical trials research.

How Can I Reduce My Risk Of Breast Cancer?

  • Diet

    There is no one single diet, food or supplement that can prevent or lower your risk of breast cancer. However, a healthy diet is still important to prevent against disease. Researchers have found that weight gain in middle life increases breast cancer risk.

  • Exercise

    Women can decrease their risk of breast cancer by engaging in regular exercise. Research has shown that in postmenopausal women, exercise and physical activity decreases the risk for breast cancer by changing oestrogen, insulin and insulin-like growth factor 1.

    Exercise can also positively affect other risk factors such as obesity and insulin resistance. It has also been shown that post-diagnosis physical activity in women with breast cancer can improve the survival chance of the patients. Ideally, exercise at least 30 minutes per day, 5 days per week at a moderate to high intensity.

  • Weight Control

    Obesity is associated with a 20% to 40% increased risk of breast cancer in post-menopausal women. In patients diagnosed with breast cancer, obesity is associated with a 33% increased risk of cancer recurrence and of death from any cause.

    Additionally, gaining weight as an adult is associated with an increased risk of post-menopausal breast cancer. The risk increases by about 6% for each 5 kg increase in a woman’s weight.

    However, having a higher BMI before menopause is associated with a decreased risk of premenopausal breast cancer. For each 5-unit increase in BMI, the risk of premenopausal breast cancer is decreased by about 7%. Importantly, obesity throughout life increases the risk of many other diseases such as heart disease and other cancers, leading to a higher rate of premature death.

  • Family History Awareness

    It’s important to be aware of your family history with breast cancer, as a person’s risk of being diagnosed with breast cancer increases if they have a close relative who has had breast cancer. It’s estimated that 4% of Australian women have an increased risk of breast cancer due to family history, and only 1% are at high risk due to a strong family history.

    Approximately 5-10% of breast cancers are due to a strong family history of genetic mutation such as BRCA1 or BRCA2. Some women with strong family histories receive genetic testing for breast cancer to see if they have one of these mutations.

  • Alcohol

    Globally, alcohol is identified as a risk factor for a range of soft tissue cancers, including breast cancer [6]. It’s estimated that approximately 17 per cent of Australians drink alcohol at levels that put them at risk of harm over their lifetime. Alcohol is the most-established dietary risk factor, thought to be due to the increase of endogenous oestrogen levels it causes.

    Women who drink one standard glass of alcohol (10g) a day have a 7 per cent higher risk of breast cancer than women who never drink alcohol. In Australia, it is estimated than almost 6 per cent of breast cancer cases each year are caused by alcohol consumption.

    Evidence suggests there is no safe level of alcohol consumption in regard to an increased breast cancer risk, with a meta-analysis of 222 articles finding even light drinking (up to one drink per day) increases the risk of female breast cancer.

  • Smoking

    Several studies have shown there is an association between tobacco smoking and the risk of breast cancer. This association is observed particularly in women who smoke for a long time, or who smoke for a long time prior to their first pregnancy.

    Tobacco smoke contains more than 5000 chemical compounds, including more than 70 that are known to be carcinogenic. Smoking has been found to be a major cause of heart disease, lung cancer and many other cancers, therefore not smoking is the best choice for your health.

  • Medication

    Tamoxifen, a medication that is commonly used to treat breast cancer, also helps prevent breast cancer from occurring. It may be considered for women who are at a high risk of breast cancer due to their personal or family history.

The Importance of Breast Cancer Screening

The earlier breast cancer is found, the better the chance of survival. Screening mammography can detect breast cancer at its earliest state, before it can be felt.

BreastScreen Australia recommends women aged 50-74 without breast cancer symptoms should have a screening mammograms every two years. This is the targeted age group as more than 75% of breast cancers occur in women aged over 50. Women aged 40-49 and 75 and over are eligible to receive free mammograms but do not receive an invitation to attend.

In New Zealand, women aged between 45 and 69 years are able to receive a free mammogram every two years.

Ways to Prevent Breast Cancer

Medical Interventions

There are several medical interventions available to help prevent breast cancer, particularly for individuals at higher risk due to genetic factors, family history, or other risk factors. These interventions include medications, surgeries, and other medical strategies based on an individual’s risk profile.

  • Risk-reducing medications: Certain medications can help lower the risk of developing breast cancer, especially those that are hormone-receptor positive. These can include tamoxifen, anastrozole, and exemestane.

Surgical Options

For individuals with a very high risk (e.g., BRCA1/BRCA2 mutation carriers), surgery can dramatically reduce the risk of breast cancer.

  • Prophylactic (Preventive) Mastectomy: Involves the surgical removal of one or both breasts before cancer develops. Reduces breast cancer risk by up to 95% in high-risk individuals.

Removing Ovaries to Prevent Breast Cancer

A Prophylactic Oophorectomy is the removal of the ovaries and fallopian tubes to lower estrogen levels, reducing the risk of both breast and ovarian cancers. This is often recommended for women with genetic mutations like BRCA1/2, especially after childbearing.

Benefits of Oopherectomy:

  • Reduced Cancer Risk: For premenopausal women, oophorectomy lowers estrogen levels, reducing the risk of hormone-receptor-positive breast cancer by up to 50%. In relation to ovarian cancer, reduces the risk by up to 95% in high-risk individuals (e.g., BRCA mutation carriers).
  • Improved Survival: Studies suggest that prophylactic oophorectomy can significantly increase life expectancy for women with genetic predispositions to breast or ovarian cancer.
  • Simplicity of Proceedure: An oopherectomy is a relatively straightforward surgical procedure, often performed laparoscopically (minimally invasive), with a shorter recovery time than more extensive surgeries.
  • Eliminated Future Ovarian Issues: Prevents benign (non-cancerous) ovarian conditions, such as ovarian cysts or endometriosis, which can require further treatment.

Risk Associated with Oopherectomy:

  • Surgical Risks: This can include typical risks of surgery such as bleeding, infection, and adverse reactions to anesthesia. Rare complications associated with surgical proceedures can include damage to nearby organs like the bladder or intestines.
  • Premature Menopause: Unfortinately for premenopausal women, oophorectomy causes immediate menopause. Symptoms include hot flashes, night sweats, vaginal dryness, mood swings, and sleep disturbances. This may increase the risk of osteoporosis, heart disease, and cognitive decline due to the loss of estrogen.
  • Impact on Fertility: Permanently ends the ability to conceive naturally, which can be a significant consideration for younger women.
  • Potential Psychological Impacts: Loss of fertility and the sudden onset of menopause can lead to feelings of grief, anxiety, or depression. Some women may experience a reduced sense of femininity or sexual confidence.
  • Residual Cancer Risk: Oophorectomy does not eliminate all cancer risk. There’s still a slight chance of developing primary peritoneal cancer (a rare cancer that arises in the lining of the abdomen, which shares origins with ovarian tissue).

Removing Breast Tissue to Prevent Breast Cancer

A prophylactic mastectomy is the surgical removal of one or both breasts in individuals who do not have breast cancer but are at high risk of developing it. This preventive procedure is intended to significantly reduce the risk of breast cancer, especially in those with genetic predispositions or other high-risk factors.

This procedure is typically recommended for individuals at high risk of breast cancer, including:

Genetic Risk:

  • BRCA1/BRCA2 Mutations: Women with these mutations have up to a 72% lifetime risk of breast cancer.
  • Other gene mutations like PALB2, TP53, and CHEK2.

Strong Family History:

  • Multiple close relatives (e.g., mother, sister, or daughter) diagnosed with breast or ovarian cancer, especially at a young age.

Personal Medical History:

  • Previous cancer in one breast (may opt for removal of the other breast to prevent future cancer).
  • History of atypical hyperplasia or lobular carcinoma in situ (LCIS), which are precancerous conditions.

Dense Breast Tissue:

  • Dense tissue can make cancer harder to detect with imaging and may slightly increase cancer risk.

The decision to undergo a prophylactic mastectomy is highly personal and depends on:

  • Your genetic risk profile.
  • Family and personal medical history.
  • Emotional readiness for the physical and psychological impact.
  • Long-term lifestyle and health goals.

Consult with a genetic counselor, oncologist, and plastic surgeon to fully understand the risks, benefits, and alternatives before making a decision. Other options, such as enhanced screening or chemoprevention, may also be worth exploring for risk management.

FAQs

Does Breastfeeding Prevent Breast Cancer?

Breastfeeding has been shown to lower the risk of breast cancer, particularly for hormone-receptor-positive types. The protective effect occurs for several reasons. First, breastfeeding lowers estrogen levels in the body during lactation. Since some types of breast cancer are fueled by estrogen, this reduced exposure to the hormone can help decrease the risk.

Additionally, breastfeeding causes the body to shed breast tissue, potentially removing cells with DNA damage that could otherwise develop into cancer. Breastfeeding also delays the return of menstruation, which reduces lifetime exposure to estrogen and progesterone, further lowering cancer risk. Moreover, the act of breastfeeding induces changes in breast cells that may make them more resistant to cancerous transformations.

The protective effect of breastfeeding increases with the duration of breastfeeding. Research suggests that breastfeeding for at least 12 months (across all children) may reduce breast cancer risk by 4–5% per year of breastfeeding. The longer the duration, the greater the benefit. Exclusive breastfeeding, where no formula feeding is involved, seems to enhance this protective effect even further.

Does Breast Massage Prevent Cancer?

Breast massage does not prevent breast cancer. While some people believe that regular breast massage can help with early detection by making it easier to feel lumps or changes in the breast tissue, there is no scientific evidence to support the idea that breast massage itself can prevent the development of cancer.

Breast cancer is a complex disease influenced by factors such as genetics, hormones, age, and lifestyle choices. While maintaining regular self-exams is an important part of breast health, it is the early detection of changes—such as lumps, thickening, or skin changes—that matters most for finding cancer at an early stage. However, breast massage is not a substitute for regular screenings, such as mammograms or clinical breast exams, which are proven to be more effective in detecting breast cancer.

Do Breast Implants Prevent Breast Cancer?

Breast implants do not prevent breast cancer. In fact, they do not offer any protective benefits against the development of breast cancer. While breast implants may change the appearance of the breasts, they do not affect the underlying risk factors associated with breast cancer, such as genetics, age, or lifestyle.

However, it is important to note that breast implants can make it more challenging to detect breast cancer through routine screening methods like mammograms. The implants can obscure breast tissue, potentially hiding tumors or making it more difficult for radiologists to interpret results accurately. Special imaging techniques, such as additional views during mammography or breast MRI, are sometimes used to help get clearer images for women with implants.

While breast implants themselves do not prevent cancer, they are not directly linked to an increased risk of breast cancer either. There are, however, certain rare conditions associated with breast implants, such as anaplastic large cell lymphoma (ALCL), a type of cancer that can develop in the tissue surrounding the implant. This is not the same as breast cancer but is an important consideration for women with implants.

Does Breast Reduction Prevent Breast Cancer?

Breast reduction surgery does not prevent breast cancer, but it may reduce some of the risks associated with the disease. The procedure involves the removal of excess breast tissue to reduce breast size and alleviate discomfort, particularly for women with very large breasts. While this can improve physical and emotional well-being, it does not eliminate the risk factors for breast cancer, such as genetics, age, or lifestyle.

One indirect benefit of breast reduction is that it can make it easier for individuals to perform regular self-breast exams and undergo screenings like mammograms. With smaller breasts, there may be less tissue to examine, which could lead to a more accurate detection of any potential changes or lumps. However, breast reduction does not remove all of the breast tissue, so regular screenings and exams are still necessary.

There is also some evidence that breast reduction might slightly lower the risk of developing breast cancer by removing some of the breast tissue that could potentially develop into cancer. However, this effect is minimal, and breast cancer prevention still largely depends on factors like genetics, lifestyle choices, and routine screening practices.

How You Can Help

We want to ensure no more lives are cut short by breast cancer. Support our life changing research with a donation, or participate in a clinical trial to help us to find a cure.

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SOLACE – A CLINICAL TRIAL FOR BREAST AND OVARIAN CANCER

The SOLACE clinical trial was for women or men who had been diagnosed with advanced BRCA-associated breast cancer, triple negative breast cancer or serious ovarian cancer. Listen in to see how these results are informing current research into ovarian and breast cancer. Professor Prue Francis discusses the results from this trial and how the knowledge gained is being used in current research.

What Is The SOLACE Clinical Trial?

The Breast Cancer Trials SOLACE trial was a clinical trial for men and women with BRCA-associated breast cancer, triple negative breast cancer or serious ovarian cancer.

SOLACE was an important trial for the treatment of ovarian cancer, and the results and treatments from this trial are being further investigated in more recent breast cancer clinical trials like OlympiA.

Medical Oncologist Professor Prue Francis is the Chair of the Breast Cancer Trials Scientific Advisory Committee.

She said the aim of the trial was to determine the appropriate doses of a new combination drug treatment.

“It was trying to look at combining a drug called Olaparib, which is a PARP inhibitor, with a very common chemotherapy drug; Cyclophosphamide.”

“The SOLACE trial involved women having an all tablet therapy, Olaparib; the PARP inhibitor as tablets and the Cyclophosphamide as tablets, and it was studying a couple of different groups of women.”

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Professor Prue Francis discusses the results from the SOLACE trial and how the knowledge gained is being used in current research.

A Trial For Breast And Ovarian Cancer

Professor Prue Francis it was important to include women with breast and ovarian cancers in the trial.

“The reason we included both breast and ovarian cancer was because PARP inhibitors like Olaparib are potentially active in women who have a genetic mutation called the BRCA-1 mutation or the BRCA-2 mutation and those mutations are associated potentially with both breast and ovarian cancer.”

“Women could participate in the trial if they had either breast cancer and had one of these gene mutations or if they had triple negative breast cancer- so that’s a breast cancer that doesn’t express oestrogen or progesterone receptor and doesn’t over express HER2.”

“In ovarian cancer, there were women who had high grade serious ovarian cancer or who had one of these BRCA mutations in association with their ovarian cancers.”

Associate Professor Francis said the trial allowed people to participate who had already received a number prior therapies for their advanced disease and for breast cancer.

“The trial approach didn’t look particularly promising for the future in that setting, and so perhaps if we were looking at that approach in breast cancer with a PARP inhibitor, we’d be needing to think about it earlier in the therapy stage.”

“For example, since we’ve started conducting the SOLACE trial, Olaparib the PARP inhibitor, has been approved in Australia for women with earlier breast cancer, as in advanced breast cancer but in an earlier therapy setting, because there if some efficacy there.”

Further Research On Olaparib – OlympiA

Since the SOLACE trial, Breast Cancer Trials has continued to study Olaparib in the OlympiA trial, for women who have completed their surgery and other local therapies.

The OlympiA study is open to those with HER2 negative breast cancer who also have inherited BRCA1 and BRCA2 mutations.

“So, the drug itself is still being actively studied in breast cancer, but in the actual SOLACE trial for the women who’d had quite a few different therapies for their advanced breast cancer, we did not see long periods of control in that context” said Associate Professor Francis.

However, SOLACE has provided further opportunities for study for those with ovarian cancer.

“The gynaecology oncologists are actually interested in the results of SOLACE because for the women with ovarian cancer and particularly those who had the BRCA mutations, they did get reasonable periods of tumour control with that combination” said Associate Professor Prue Francis.

“It is an interesting combination for them to go and study further in that particular setting.”

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Breast Cancer Trials Researcher and Clinical Head of Breast Medical Oncology at the Peter MacCallum Cancer Centre.

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DENSE BREASTS

Dense breasts are more common in young woman and women with dense breasts can be five times more likely to develop breast cancer.

What Are Dense Breasts & How Do I Know If I Have Them?

Do you know if your breasts are dense?

Dense breasts are more common in young woman and women with dense breasts can be five times more likely to develop breast cancer.

However, it is not something that is commonly discussed between doctor and patient.

Rik Thompson is the Associate Director and a Professor of Breast Cancer Research at the Institute of Health and Biomedical Innovation and School of Biomedical Science at Queensland’s University of Technology. He is also a Breast Cancer Trials Board Member.

A research focus for Professor Thompson is mammographic density or dense breasts.

What Is Mammographic Density?

“Mammographic density is the whiteness on your mammogram” said Professor Thompson.

“Without having a cancer in it, the normal breast mammogram can either be quite dark or will have different amounts of whiteness in it and it’s the whiteness which is the mammographic density.”

Professor Thompson said its not possible to know if you have dense breasts by feel or touch alone.

“It’s not dense to touch, it’s not a lump, it’s not firm but it blocks x-rays.”

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Dense breasts are more common in young woman and women with dense breasts can be five times more likely to develop breast cancer.

Research Into Mammographic Density (Dense Breasts)

Research into mammographic density is incredibly important as your risk of breast cancer is higher if you have dense breasts, but researchers are not yet sure why.

“It’s linked with oestrogen action which is known to be a promoter for breast cancer” said Professor Thompson.

“It’s got some genetic links. So, some of the genes which are linked to mammographic density are the same as those that have an effect on breast cancer predisposition and risk, but a lot of them are not.”

“We’re trying to find out at a molecular level why are the cells in those dense regions, or in denser breasts, are more likely to end up becoming a breast cancer.”

How Common Are Dense Breasts?

Around 45% of women have dense breasts according to Professor Thompson. However, as Australia does not have a notification process surrounding mammographic density, many woman are unaware of it.

“It’s something that’s being hotly debated and investigated and considered in Australia.”

“There’s quite a number of approaches and workshops and special initiatives to try and understand how best to deal with this information, how to accommodate it, how to afford it, how to pass it on in a meaningful way.”

What Do I Do If I Have Dense Breasts?

If women are concerned about mammographic density, they could take a look at their mammogram and discuss mammographic density with their GP said Professor Thompson.

“I think most women could look at the literature and look at the websites around mammographic density and have a look at their mammogram and they could get a pretty good picture as to whether they’re dense or not.”

“It’s certainly something that I think increasingly women could discuss with their GP.”

If you are aware of your mammographic density, Professor Thompson stresses that you should still get regular screening.

“I think the most important thing even if mammograms don’t work as well in dense breasts because it can mask it, mammography is still the best way to find breast cancers, even in the densest scenario.”

“Women shouldn’t ever think ‘I won’t get a mammogram anymore, it doesn’t help me, my breasts are too dense’. You can still find breast cancers and it’s very clear from all the professional groups that it’s paramount.”

He also said that having dense breasts is no cause for alarm.

“Mammographic Density is only one of a number of risk factors for breast cancer.”

“You could have the densest breasts in the world but if you had no other risk factors, you’re probably still fine.”

“So, you’ve got to look at your family history, you’ve got to look at your age, your BMI, and all of those factors that are well established and so, it’s really a composite assessment of risk that probably should be what’s used to think about what to do next.”

If you would like to learn more about mammographic density, you can visit www.informd.org.au

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Professor Rik Thompson

Professor Rik Thompson is the Associate Director and a Professor of Breast Cancer Research at the Institute of Health and Biomedical Innovation and School of Biomedical Science at Queensland’s University of Technology.

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WHAT’S IT LIKE TO PARTICIPATE IN A CLINICAL TRIAL?

More than 15,000 women have participated in Breast Cancer Trials clinical trials. One of those women is Leslie Gilham, who was a participant in the TEXT clinical trial, a practice changing study for the treatment of young women with breast cancer.

The Importance Of Clinical Trials

In the past 20 years, the chance of surviving five years after a breast cancer diagnosis in Australia has increased from 73% to 91%.

It is thanks to the incredible advances in breast cancer research that we have seen these improvements in survival rates.

But without clinical trial participants these advances could not have been possible.

More than 15,000 women have participated in more than 80 Breast Cancer Trials clinical trials.

One of those women is Leslie Gilham, who was a participant in the TEXT clinical trial.

The TEXT Clinical Trial

TEXT was a practice changing study into the treatment of breast cancer in young women.

It showed that the aromatase inhibitor, exemestane, is more effective than tamoxifen in preventing breast cancer coming back in young women who also receive ovarian function suppression.

However, Leslie said she had not heard of clinical trials until her first meeting with her oncologist.

“We went through my treatment plan and he raised the possibility of there being a clinical trial that I might be suitable for and would I be interested?”

“So, I took away all the information for the trial and had time to consider it and weigh up whether I wanted to participate, and I did.”

TEXT was a randomised trial, with half the participants receiving Tamoxifen and half an aromatase inhibitor.

It also involved having triptorelin to suppress the patient’s ovaries and put them through menopause.
Leslie said she felt she was well-informed about the trial before signing on.

“I had a meeting with my oncologist who suggested the trial and he brought in the research nurse.”

“So, they basically went through the whole protocol for the trial with me and discussed it in detail and probably for around about an hour” she said.

“Then I was given the protocol and the informed consent to take home and consider and so I could go home and discuss it with my family, whether to participate or not, and then basically made the decision and came back agreed to participate. “

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More than 15,000 women have participated in Breast Cancer Trials clinical trials. One of those women is Leslie Gilham, who was a participant in the TEXT clinical trial, a practice changing study for the treatment of young women with breast cancer.

The Benefits Of Participating In A Clinical Trial

Leslie said she felt fully supported throughout the duration of her trial.

“Part of the trial was that you had to attend the clinic more often than the average patient.”

“I was also constantly receiving phone calls from the research team and I also had to fill out quality of life studies, so you’re sort of more aware of where you are at, and I guess the treatment itself.”

“I mean statistics show that people on trials do better than people off trial and I think that’s basically because you get more support from the team while you’re on trial.”

Leslie said although the support was an added bonus, her reasons for participating in a clinical trial was closer to her heart.

“I had a friend who was diagnosed five years prior to me and one the drugs, if she was diagnosed at the same time as me, she would have had access to.”

“But she didn’t have access to it, and I’m pretty sure she would not have passed away if she had access to that drug” said Leslie.

“So, I guess it brought it home to me, the importance of the treatments improving all the time and the survival rates improving as a result of that. So, I guess that and the combination of having a daughter.”

“I was very keen on playing my part to improving treatments and overall survival rates.”

Leslie said she is proud her participation in a clinical trial has helped inform practice for how breast cancer is treated in Australia and New Zealand.

“It was because of the (trial) data that was collected that they said it would now be the standard treatment or gold-standard treatment for my type of breast cancer.”

“I was a little bit proud because I thought, well it was worth participating and it was worth putting my hand up and hopefully making a difference to the future generations.”

Leslie recommends participating in a clinical trial to anyone who is provided the opportunity.

“When you’ve got a diagnosis, and you’ve got so many things going on in your head at the time, it’s good to be able to focus on something and I found that was a really good way of being able to get through my treatments.”

“But also, it’s that ability to hopefully make a difference.”

“The other thing that I found really important and really fulfilling was I felt like I was part of a team, being the research team.”

“They included me in every decision process. I always remember, other than the day I was diagnosed, the hardest day was saying goodbye to my research team after five years.”

Leslie Gilham is a past clinical trial participant and the current chair of the Breast Cancer Trials Consumer Advisory Panel.

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Leslie Gilham is the Chair of the Breast Cancer Trials Consumer Advisory Panel

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UNDERSTANDING BREAST CANCER STATISTICS & SURVIVAL RATES

Collating breast cancer statistics is important in order to track how many people are being diagnosed with and surviving breast cancer each year. These statistics allows us to track how improved treatments and screening techniques have contributed to better survival rates.

Why Are Breast Cancer Statistics & Survival Rates Important?

Collating breast cancer statistics is important in order to track how many people are being diagnosed with and surviving breast cancer each year. These statistics allows us to track how improved treatments and screening techniques have contributed to better survival rates.

It is also important to record how different factors can vary these statistics. For example: types of cancer, stage of cancer, age and gender.

This information allows doctors to better inform their patients of their individualised survival chances, which can also help to inform treatments.

New Cases of Breast Cancer

In 2019, the Australian Institute of Health and Welfare predicts 19,371 women and 164 men in Australia will receive a breast cancer diagnosis. In New Zealand, approximately 3,500 people will be diagnosed with breast cancer. It is the most commonly diagnosed cancer for Australian and New Zealand women.

The number of people diagnosed with breast cancer has steadily increased over time, however survival rates have improved. In the past 20 years, the five-year relative survival rate for early stage breast cancer has increased from 73% to 91% in Australia. In New Zealand, the chance of surviving five years is 88%. The chance of surviving at least ten years in Australia is 83%, while in New Zealand it is 80-95%, if detected early via a mammogram.

Survival Statistics By Stage of Diagnosis

The relative five-year survival rate for a female diagnosed with breast cancer in its earliest stage or stage one is effectively 100%, according to 2011 data from the Australian Institute of Health and Welfare. When females are diagnosed with metastatic breast cancer (advanced or stage four), the 5-year survival rate is reduced to 32%1. This highlights the important of detecting cancer at an earlier stage to improve survival chances.

On average, breast cancer in females is diagnosed at stage one or two. The higher proportion of cases diagnosed as stage one and two for breast cancer may be partly attributable to the national breast cancer screening program.

Breast Cancer Mortality Rates

In 2019, the Australian Institute of Health and Welfare estimates 3,090 people will die from breast cancer. It is the 4th leading cause of death from cancer in Australia. The risk of dying from breast cancer before age 75 is 1 in 78 for women, and 1 in 7,922 in males. The risk of dying from breast cancer before age 85 is 1 in 43 for women and 1 in 3,455 for males.

In New Zealand, approximately 630 people will die from breast cancer this year. About 70% of women who are diagnosed with breast cancer and about 80% of women who die from it are 50 years or older.

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COMMON BREAST CANCER
MYTHS AND FACTS

There are a lot of myths regarding breast cancer and this can make it difficult to separate fact from fiction. Here are just some of the common breast cancer myths explained:

Common Breast Cancer Myths And Facts

There are a lot of myths regarding breast cancer and this can make it difficult to separate fact from fiction. Here are just some of the common breast cancer myths explained:

  • Myth: Only Women Get Breast Cancer

    Although it is less common, men can get breast cancer. Male breast cancer accounts for less than 1% of all breast cancers diagnosed.

    Approximately, 164 men will be diagnosed with breast cancer in Australia this year and around 25 men in New Zealand. Treatment for both men and women diagnosed with breast cancer are very similar.

  • Myth: Wearing An Underwire Bra Can Cause Breast Cancer

    Every so often this myth will gain traction on the internet, but there is no credible evidence to back it up.

    A 2005 population-based case-control study of around 1,500 women diagnosed with two of the most common histological types of breast cancer, invasive ductal carcinoma cases (IDC) and invasive lobular carcinoma (ILC) and a control group of women, found no aspect of bra wearing, including bra cup size, average number of hours/day worn, wearing a bra with an underwire or age when first began regularly wearing a bra, was associated with risks of any of the most common types of breast cancer.

    The myth about a link between wearing an underwire bra and breast cancer comes from concern about bras impeding lymphatic drainage, interfering with toxin removal. Another theory without any factual basis is that bras cause cancer by increasing the surface temperature of the breast.

    To be clear, there are NO credible scientific studies or any other evidence of any association between any aspect of wearing a bra and breast cancer risk.

  • Myth: Breast Implants Increase The Risk Of Breast Cancer

    Several studies have been completed examining if there is a connection between silicone-filled breast implants and breast cancer.

    In these studies, there was no conclusive evidence found that women who have undergone cosmetic breast implantation have an increased risk of the most common types of breast cancer.

    However, there is an extremely rare condition associated with breast implants; breast implant associated anaplastic large cell lymphoma.

  • Myth: Contraceptive Pills Cause Breast Cancer

    Taking oral contraceptives or ‘the pill’ has been associated with a small increased risk of breast cancer while the woman is currently using it.

    The risk of being diagnosed with breast cancer for women using the ‘combined’ oral contraceptive pill increases by about 7% for every five years of use.

    However, this risk is reduced when the woman stops taking it.

  • Myth: All Breast Cancer Types Are Genetic

    A person’s risk of being diagnosed with breast cancer increases if they have a close relative who has had breast cancer – on either their mother’s or father’s side – particularly if they were diagnosed under the age of 50.

    However, most women who develop breast cancer have no family history of the disease. The majority of breast cancer diagnoses are not linked to an inherited gene.

    It is estimated that 95% of Australian women are of average risk, 4% have an increased risk of breast cancer due to family history, and only 1% are at high risk due to a strong family history.

    Of these 1%, only half have a known gene that is likely to have been inherited from their mother of father’s side. The other half may have an inherited gene that we do not yet have a test for.

    Genetic Risks for Developing Breast Cancer

    • Women with one first-degree relative (parent, sibling or child) who has had breast cancer have almost two times the risk of breast cancer compared to women with no family history.
    • Women with two first degree relatives who have received a breast cancer diagnosis, have almost three times the risk of developing breast cancer compared to women with no family history.
    • Women with three or more first-degree relatives are almost four times as likely to be diagnosed with breast cancer.
    • If a woman has one or more second degree relatives who have received a breast cancer diagnosis (aunt, uncle, grandparent, grandchild, niece, nephew or half-sibling) they are estimated to have one and a half times the risk of being diagnosed with breast cancer compared with someone who has no family history.

    As breast cancer is the most commonly diagnosed breast cancer in Australia, some women will have a family history of the disease by chance.

    However, some woman may have inherited a faulty or mutated gene, like BRCA1 or BRCA2, which increases the risk of cancer. Around 5-10% of breast cancers are due to an inherited gene like BRCA1 or BRCA2.

  • Myth: Deodorants and Antiperspirants May Cause Breast Cancer

    There is no evidence that deodorants or antiperspirants cause breast cancer. This myth was perpetuated by several poor-quality studies.

    These studies proposed a theoretical link between deodorants and antiperspirants containing chemicals such as parabens and aluminium compounds that are applied close to where breast cancer can develop.

    However, a high-quality systematic review of all available studies showed there is no reliable evidence to suggest that the use of deodorants or antiperspirants increases the risk of breast cancer.

  • Myth: All Lumps In The Breast Are Cancerous

    Most lumps in the breast are not cancerous. Most breast changes are likely to be normal or due to a benign breast condition. Some benign breast changes may need treatment, but this is not always the case.

    However, if you do notice a change in your breasts, you should discuss this with your GP to make sure that the changes are not something more serious.

    Changes to look out for include new lumps in the breast or under the arm, nipple inversion or discharge, skin thickening or swelling.

  • Myth: Fertility Treatments Can Cause Breast Cancer

    The is no clear or conclusive evidence that hormonal treatment for infertility can cause an increased risk of breast cancer.

    An analysis of 20 studies found hormonal infertility treatments are not associated with an increase BC risk.

    There was also no increased risk found in women undergoing IVF treatment.

HELP CHANGE HER STORY, SUPPORT BREAST CANCER RESEARCH

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BREAST CANCER SYMPTOMS

It can be an incredibly frightening experience to find a lump on your breast that you have never noticed before. It is the most discussed symptom of breast cancer. Associate Professor Nicolas Wilcken discusses this and other symptoms of breast cancer, and what to do if you spot any of them.

The Signs And Symptoms Of Breast Cancer

It can be an incredibly frightening experience to find a lump on your breast that you have never noticed before. It is the most discussed symptom of breast cancer.

But do you know what you should do after finding a lump? Do you know what other symptoms you should be on the lookout for? Does a lump necessarily mean you have breast cancer? And is a monthly self-check of our breasts really necessary?

What Do You Do When You Find A Breast Abnormality?

Breast Cancer Trials board member and Medical Oncologist Associate Professor Nicholas Wilcken said some breast cancers show no symptoms to begin with, but it’s important not to panic if you do find a breast abnormality.

“I think the first thing to say about symptoms of breast cancer is often there are very few or there aren’t any” said Associate Professor Wilken.

“Second thing to say is that breast cancer is not an emergency. If you think there is something abnormal about your breasts, you don’t want to sit around watching that for six to 12 months, but nor do you have to panic and see the doctor in a week or two time. You can afford to wait three or four weeks and see is this really different? Is this really new? Is this really something happening?”

“In terms of what you might see, if you’re looking at yourself in the mirror with your hands on your head, you may see that there is some asymmetry, or some part of the breast pulled in. When I say asymmetry, it is quite common for one breast to be slightly bigger than the other, so I don’t mean that, but I mean some unevenness” he said.

“The second thing to look for is the nipples and in some women their nipples are already always withdrawn and, on both sides, and that’s fine, that’s totally ok. But if a nipple that used to be pointing out is now tugging in that’s probably not right. Again, wait for three or four weeks but that’s something to talk to the doctor about.”

“And the third thing is rash or red raised plaques on the skin is highly likely to be something completely benign. It’s just an allergy or something like that, but if that persists for three or four weeks that’s worth talking to the doctor about as well.”

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Associate Professor Nicolas Wilcken discusses the other symptoms of breast cancer, and what to do if you spot any of them.

Non-Visible Symptoms Of Breast Cancer

Professor Wilcken said there are also non-visible symptoms which women should be aware of.

“You naturally assume ‘if I’ve got cancer in my breast it’s going to hurt’. So, I’ll watch out for breast pain but in fact, breast cancers very uncommonly hurt and if you’ve got something causing breast pain, I’m not saying ignore it, wait and see and if it persists, see the doctor. But it’s probably going to turn out not to be breast cancer.”

He said if you have any of those symptoms, you should not panic.

“As I say, it’s something to take seriously, it’s potentially important but it’s not urgent. It’s always a good idea to wait three or four weeks. I think particularity if you’re a pre-menopausal woman and you’re having regular periods as you all know, breasts change through the cycle.”

“It’s better to wait for a month and see if whatever you think was wrong or you were starting to panic about, might just settle down on its own.”

Should You Self-Check?

Woman are often encouraged to self-check regularly, however Associate Professor Wilcken said this is a complicated discussion.

“The whole self-checking argument is complicated.”

“On the one hand you want to know what your breasts feel like if you’re having a menstrual cycle and you want to know how they change for the cycle, so you can recognise if something feels abnormal.”

“But in fact, interestingly, if you very carefully train women to examine their breast for abnormalities, what’s been shown in a clinical trial is that that actually doesn’t help. Because you get lots of women talking to lots of doctors, having lots of mammograms, and lots of biopsies and almost all of it is not breast cancer. So, you actually create more problems than you solve” he said.

“So, it’s this halfway thing of don’t completely ignore your breasts but don’t do a religious really careful examination. It’s a kind of once over, three times or four times a year.”

“If you see something different, you note it, you wait and you watch and if two or three weeks later it’s still the same, you see the doctor for a check-up.”

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Associate Professor Nicholas Wilcken

Associate Professor Nicholas Wilcken is the Director of Medical Oncology at the Crown Princess Mary Cancer Centre Westmead, Senior Staff Specialist at Nepean Hospital and Associate Professor of Medicine at the University of Sydney.

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WHY ARE MORE WOMEN BEING DIAGNOSED WITH BREAST CANCER?

In Australia and New Zealand, the number of people of people being diagnosed with breast cancer is increasing. However, the breast cancer mortality rate is in decline, which means less people are dying from this disease.

Cancer Cases Increasing Worldwide

In Australia and New Zealand, the number of people of people being diagnosed with breast cancer is increasing.

In fact, the Australian Institute of Health and Welfare estimates that this year, breast cancer will be the most commonly diagnosed cancer in Australia, taking over from Prostate Cancer.

This means more than 19 thousand people in Australia and three and a half thousand people in New Zealand will receive a breast cancer diagnosis this year.

However, the breast cancer mortality rate is in decline, which means less people are dying from this disease.

To help make sense of this data, we sat down with Associate Professor Nicholas Wilcken, a Medical Oncologist and Breast Cancer Trials Board Member.

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In Australia and New Zealand, the number of people of people being diagnosed with breast cancer is increasing. However, the breast cancer mortality rate is in decline, which means less people are dying from this disease. To help make sense of why this is, we sat down with Associate Professor Nicholas Wilcken, a Medical Oncologist and Breast Cancer Trials Board Member.

Why are Breast Cancer Cases Increasing in Australia and New Zealand?

We asked him if we know why the number of women and men being diagnosed with breast cancer is increasing.

“As a sort of a short cut, breast cancer is in some ways a disease of affluence.”

“Not meaning that poor women don’t get breast cancer but meaning, when you compare rich parts of a country with poor parts of a country or rich countries versus poor countries, or poor countries that are getting richer, like China, what you find is as you become more affluent you get more breast cancer. And that’s thought to be due to a number of factors” he said.

“Some of them are kind of reproductive factors. So, as you live as we do, in a better nourished world, so we’re not starving, we’re not losing weight – that sort of stuff, what you actually find is the age at which women first start getting their periods gets lower. So, in Australia the average is 12. If you go to a poor rural part of China, it’s more like 17 or 18 and that has an impact. That does slightly increase the risk of breast cancer. Similarly, menopause might be a bit later and that slightly increases the risk and then also our pattern of childbearing changes.”

“So, in more impoverished countries women tend to get pregnant very early and that makes breast cancer less likely. I’m not obviously suggesting getting pregnant very early is a good idea but what happens, say as a country becomes more westernised is that women have children later and later for obvious, good reasons, but that does slightly increase your risk of breast cancer. If you’re in a poor country, you will do a lot of breast feeding and you’ll be breast feeding the child for two or three years and that’s protective. Whereas we tend not to do that in Australia.”

Associate Professor Wilcken noted that the ageing population has impacted this number as well, but only slightly.

“Obviously if you don’t die of pneumonia when you’re a kid or a heart attack when you’re middle aged and you’re going to live for longer, you’ve got a bigger chance of getting breast cancer. But I think the main drivers are those hormonal factors to do with periods, childbirth, and being over-nourished.”

Breast Cancer Mortality Is Decreasing

Though we have seen an increase in the number of women being diagnosed, we have also seen a significant decrease in the mortality rate of women being diagnosed with breast cancer.

“The number of deaths has decreased massively” said Associate Professor Wilcken

“Over the last 25 years the mortality rate, you know correct at per capita, has fallen by about 25% and most of that is actually due to clinical trials showing that giving treatments, drug treatments, after breast surgery reduces the risk of the cancer coming back. So, it’s mostly to do with drug treatments and we’ve only known about that because of clinical trials.”

“There’s also probably a component of screening. So, the more screening you have the more likely you are to find cancers a bit earlier and some of those you’ll find early enough that you’ve cured the woman, that you’d otherwise wouldn’t have.”

“The number will continue to decline, although I think we’ve seen the biggest decline since 1990 when these treatments started being used regularly” said Associate Professor Wilcken.

“We’ve had a big fall from say 1990 to 2015, and we’ll continue to have falls, but it’ll be at a slower rate. In other words, we’ve done a lot of the heavy lifting, there’s obviously more to do and that will be slow incremental benefits.”

He said although the mortality rates are important, it’s also worth remember the quality of life improvements that have also been made thanks to clinical trials research.

“The experience of getting breast cancer is obviously very challenging but it’s gradually getting much easier to manage than it was say 20 years ago. For a whole bunch of reasons. The drugs are smarter, the anti-nausea medications are better, the pain medications are better and so on.”

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Associate Professor Nicholas Wilcken

Associate Professor Nicholas Wilcken is the Director of Medical Oncology at the Crown Princess Mary Cancer Centre Westmead, Senior Staff Specialist at Nepean Hospital and Associate Professor of Medicine at the University of Sydney.

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HOW COMMON IS BREAST CANCER?

Breast Cancer is the most common cancer in women in Australia and New Zealand. In 2019, it’s estimated breast cancer will be the most commonly diagnosed cancer in Australia. The risk of being diagnosed with breast cancer in Australia by age 85 is 1 in 7 for women and 1 in 675 for men. In New Zealand, the risk of being diagnosed with breast cancer is 1 in 9.

How Common Is Breast Cancer?

In 2019, it is estimated that breast cancer will become the most commonly diagnosed cancer in Australia. It is estimated 19,371 women and 164 men in Australia and approximately 3,504 people in New Zealand will be diagnosed with cancer in 2019.

In Australia, breast cancer is the second most common cancer to cause death in women after lung cancer. The risk of being diagnosed with breast cancer by age 85, is 1 in 7 for women and 1 in 675 for men.

Worldwide, breast cancer is the most common cancer among women, impacting 2.1 million women each year, and is responsible for the greatest number of cancer-related deaths among women.

Last year, it is estimated that 627,000 women worldwide died from breast cancer. This is approximately 15% of all cancer deaths in women.

What Is The Most Common Type Of Breast Cancer?

Breast cancer is not just one disease, but several. It includes different subtypes, which include ER positive, HER2 positive and triple negative. Treatments are also becoming increasing personalised for patients.

The most common type of breast cancer is both oestrogen receptor (ER) positive and HER2-negative. Approximately 75% of all breast cancers are ER positive. In this type of cancer, oestrogen receptors cause cell growth, and treatment may include hormone therapy and chemotherapy.

Another important subtype is triple negative breast cancer. Around 15% of breast cancers are triple negative, which means that hormone therapy and HER2 blocking therapy are not effective. Chemotherapy is often used for this type of breast cancer.

Around 15% of breast cancers are HER2 positive. HER2 stands for human epidermal growth factor receptor 2.

HER2 is a protein created by the HER2 gene. HER2 proteins are receptors on breast cells, and are involved in normal cell growth, however sometimes the HER2 protein doesn’t work properly and cells multiply too quickly. This can cause a fast-growing breast cancer.

If too much HER2 is present in your breast cancer cells, then you have HER2 positive breast cancer. The presence of the HER2 protein causes cancer to spread more quickly to other parts of the body.

Thanks to Breast Cancer Trials, treatments for HER2 positive breast cancer have improved substantially over the last 40 years. It was thanks to the HERA clinical trial that those with HER2 positive breast cancer now have access to Herceptin, which was proven to improve survival rates when used with chemotherapy.

What Are The Most Common Symptoms Of Breast Cancer?

In the early stages of breast cancer there may be no symptoms at all. As the cancer grows, symptoms may include:

  • A new lump in the breast, armpit area or around the collarbone
  • A change in breast size or shape
  • Changes to the nipple, such are sores or crusting, an ulcer or inverted nipple
  • Clear or bloody nipple discharge
  • Changes to the skin including redness, puckering, or dimpling (an ‘orange peel’ appearance)
  • Breast tenderness or pain

It is important to know that these symptoms may not be related to cancer at all, and that there are many other causes. If you notice any of these symptoms, you should see your doctor.

How Common Is Breast Cancer In Both Breasts?

Synchronous bilateral breast cancer, or breast cancer in both breasts at the same time, is uncommon.

Breast cancer data shows that an average of 2.3% of women with invasive breast cancer in one breast also had cancer in the second breast diagnosed at the same time, or within at least three months of the first diagnosis. As you get older, the likelihood of being diagnosed with breast cancer in both breast increases.

However, five-year survival for patients with breast cancer in both breasts is not significantly different from patients with breast cancer in only one breast. Women who have been diagnosed with cancer in one breast are more likely to be diagnosed with breast cancer in the other breast at a later date. Cancer specialists will usually keep a close eye out for this.

How Common Is Breast Cancer In Your 20s?

Less than 1% of breast cancers occur in people in their 20s.

The latest data we have from the Australia Institute of Health and Welfare (AIHW) is from 2015. It shows that 17,004 people were diagnosed with breast cancer. From this 80 people were between the ages of 20-29.

There were 3 breast cancer diagnoses in people under the age of 20.

Although breast cancer can occur in your 20s, it has been shown that it is not useful for the average woman under 40 to have regular mammograms. If you have a strong family history or are concerned about your chances of developing breast cancer, speak with you GP about your screening options.

How Common Is Breast Cancer In Your 30s?

The probability of developing breast cancer in your 30s is higher than in your 20s, but is still uncommon.

According to AIWH data from 2015 , 721 people aged between 30-39 were diagnosed with breast cancer, which equates to 4% of the 17,004 people diagnosed that year.

Rates for breast cancer in younger women are lower, as your risk of being diagnosed with breast cancer increases with age.

What Is The Most Common Benign Breast Tumour?

Benign breast tumours are not cancerous and are very common.

A woman’s breasts go through many changes due to puberty, pregnancy and menopause. Most breast changes are likely to be normal or due to a benign breast condition. Some benign breast tumours may need treatment, but this is not always the case. If you notice a change in your breasts, you should discuss this with your GP.

There are several benign (not cancerous) breast conditions including; breast pain, breast cysts, duct ectasia, fibroadenoma, periductal mastitis, benign phyllodes tumour, breast calcifications, fat necrosis, intraductal papilloma, gynaecomastia, hyperplasia and atypical hyperplasia, lobular neoplasia, Mondor’s disease, sclerosing lesions of the breast and intertrigo.

How Common Are Breast Biopsies?

A breast biopsy involves the use of a needle to take a sample of a small amount of tissue to be examined under a microscope. It is done to investigate suspicious changes in the breast, that are causing symptoms or are found on routine scans.

It is very common as it is part of the ‘triple test’ to diagnose breast cancer: a physical examination, mammogram or ultrasound and then biopsy. Although other tests can point to cancer being present, only a biopsy can make a definite diagnosis.

Just because a biopsy is being done, it does not mean that there is cancer present. A breast biopsy can also show that there is no evidence of cancer present in the breast. Alternative diagnoses include the benign conditions listed above.

Types of breast biopsies include fine needle aspiration biopsy, core needle biopsy and surgical biopsy.

How Common Are Breast Calcifications?

Breast calcifications are common and are usually non-cancerous and harmless. They are small spots of calcium deposits in the breast. They are usually found during routine mammograms.

There are two kinds of breast calcifications: macrocalcifications and macrocalcifications. Macrocalcifications are not linked with cancer and require no treatment. Microcalcifications are not usually due to cancer, but a group of microcalcification can sometimes be a sign of pre-cancerous changes or early breast cancer. Microcalcifications may require further investigation and treatment.

What Is The Most Common Treatment For Breast Cancer?

The type of treatment that is used for breast cancer is dependent on several factors including the type of breast cancer, stage of breast cancer, the patients age and general health, genomic markers, where the breast cancer is in the body and the patient’s preference.

Surgery is the most common treatment for breast cancer. The smaller the tumour, the more options the patient has.

The most common types of surgery for breast cancer are lumpectomy, which can also be known as partial mastectomy or breast conserving surgery, and mastectomy. Often one or more lymph glands from the armpit will also be removed at the same time as the breast surgery, in a sentinel node biopsy or axillary dissection.

Other treatments for breast cancer include radiation therapy, chemotherapy, hormonal therapy and targeted therapy.

Is Breast Cancer In The Left Breast More Common?

Breast cancer in the left breast is not more common than breast cancer in the right breast, however some treatments may differ due to the proximity of the heart on the left side the body.

How Common Is Breast Cancer In Men?

164 men in Australia will be diagnosed with breast cancer in 2019, representing less than 1% of all breast cancer diagnoses.

Breast cancer in men is less common, but the symptoms and most of the treatment is the same. Men should be aware of the look and feel of their breasts and alert their doctor of any changes.

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BREAST CANCER LANGUAGE

What is the right thing to say to someone who has received a breast cancer diagnosis? Former CAP chair Leonie Young and current CAP chair Leslie Gilham discuss the words and phrases they liked and disliked being used about their breast cancer experience, and also told us why language choices are so important.

The Importance Of Language

UK Charity Macmillan Cancer Support conducted a poll of 2,000 people who have or had cancer, asking for their thoughts on the language used to describe their cancer experience.

‘Fighter’, ‘warrior’, ‘hero’ and other words relating back to ‘war’ or ‘battles’ were a selection of words seen as inappropriate rather than uplifting. The poll’s respondents said they preferred factual words to describe people with cancer, their diagnosis, and when someone with the illness dies.

After opening this conversation on Breast Cancer Trials social media, we heard similar responses discussing distaste for words like ‘journey’. However, others disagreed showing how divisive this language can be.

Here are some of the comments that people made on social media:

 

“There is a culture of acceptance for negative language that would be out of context for most other health conditions and I wonder if this contributes to psychological negative effects (such as staying in or returning to/ being reminded of a state of trauma or distress). The language shocked me- words like battle, fight etc… Survivor…Just can’t relate to that label.”

“I feel that in my experience using this language is a barrier to really discussing how a person with cancer is really feeling and fearing. I have had attempts at conversation with loved ones basically shut down when all I needed was someone to listen to me not say ‘be strong and you’ll be fine.’ We all have different experience with this.”

“When I was diagnosed with breast cancer. I hated the word POSITIVE. Regardless of what people say, I like the word journey.”

The Breast Cancer Trials Consumer Advisory Panel (CAP) regularly discusses the language used in patient information for breast cancer treatment and care, to help ensure a consumer perspective is provided from the very early planning stages of clinical trials.

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Former Consumer Advisory Panel (CAP) Chair Leonie Young, and current CAP Chair Leslie Gilham, speak about what words and phrases they liked and disliked being used about their breast cancer experience – explaining in their own words why language choices are so important.

Current CAP Chair, Leslie Gilham said although people are often well intentioned, sometimes language can negatively affect a woman going through treatment.

“It’s a bit like when you’re pregnant. Everyone knows someone who’s had cancer, and everyone wants to tell you what happened to their friend, or their family member and that sort of thing. So, it’s about surrounding yourself with the right people and, that peer support, because they get where you are, and they get where you’re going. So, it makes it easier to deal with it.”

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Leslie Gilham

Leslie Gilham is the Chair of the Breast Cancer Trials Consumer Advisory Panel
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Leonie Young

Former Chair of the Breast Cancer Trials Consumer Advisory Panel (CAP)

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THE POEMS BREAST CANCER CLINICAL TRIAL

The POEMS clinical trial offered a new treatment option for women with breast cancer, to better preserve their fertility during cancer treatment.

Natasha’s Participation In A Clinical Trial Has Helped Women Like Catherine To Have A Baby

There are many difficult things a woman will consider when receiving a breast cancer diagnosis.

For some young women, the ability to have children after their treatment is one of those important considerations.

43-year-old Natasha Eaton was one of those women.

She was diagnosed with triple negative breast cancer more than ten years ago and says the cancer came as a complete shock.

“I was in bed one night and I just rubbed my hand down the side of my breast and felt a lump and I freaked out and went straight to my Aunt’s place and got her to double check, and she said I better get to the doctors straight away” Natasha said.

“I was scared and terrified and it was really… I was shocked, and it was really scary.”

Natasha’s Participation In The POEMS Clinical Trial

Natasha’s oncologist, Professor Fran Boyle, knew how important becoming a mother was to Natasha, so suggested she take part in the POEMS clinical trial conducted in Australia and New Zealand by Breast Cancer Trials.

“I hadn’t really heard much, I knew there was research going on but never really been a part of it. But she was very, she gave me a lot of information, she explained it all to me. I was quite happy to go with her recommendation,” said Natasha.

The POEMS clinical trial offered a new treatment option for women with breast cancer, to better preserve their fertility during cancer treatment.

The chemotherapy many women receive during their breast cancer treatment destroys any remaining cancer cells after surgery to prevent these cells from growing and spreading to other parts of the body.

One in four breast cancer patients like Natasha are pre-menopausal and unfortunately, a common long-term side effect of the chemotherapy is early menopause.

The POEMS study, which stands for the Prevention of Early Menopause Study, took premenopausal women between the ages of 18 and 49 with breast cancer who were receiving chemotherapy and gave them the drug goserelin every four weeks.

Goserelin, sold under the brand name Zoladex, disrupts the body’s hormonal feedback systems, resulting in reduced oestrogen production.

It essentially puts the body into menopause that can be reversed after treatment.

For Natasha, it proved very successful.

She fell pregnant six months after finishing treatment.

“I was really shocked to start with because I was not expecting. It wasn’t something I was trying or anything like that, it was just something that happened, and it was a lot of mixed emotions.”

“I didn’t know what that meant to me medically, whether it was, it’s not recommended. It was a very scary time, but also a joyous time to know that it worked.”

Fast forward ten years and Natasha and her son Jack are happy, healthy and Natasha is cancer free.

 

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Country music star Catherine Britt and POEMS trial participant Natasha talk about their experience with breast cancer and the POEMS clinical trial.

How Catherine Benefited From The POEMS Clinical Trial

Goserelin is now offered to pre-menopausal women during their treatment as part of standard practice and is available on the PBS.

One of those women is Australian country music star Catherine Britt.

Catherine was diagnosed three years ago with stage 2a triple negative breast cancer at age 30.

“There’s so much that goes through your mind,” Catherine said.

“Initially, its pure shock and you don’t really process what’s been said. It feels a little like you’re in a movie or something.

“I was more, checking on everybody else, to make sure my husband and doctor telling me was ok. They were just looking at me like I was crazy,” said Catherine.

“It didn’t hit me until I got to my parent’s house and I said to my husband, how am I supposed to tell my dad that I have breast cancer.”

Catherine also had the added weight of letting her fans in on her diagnosis.

“I wanted to do it properly because once I came around, I wanted to use it as a tool to promote people checking themselves.”

“I’m here today because I’m pro-active about my health, and that’s the only reason, because I’m a total hypochondriac. But it saved my life, and I’ll never feel guilty about that ever again.”

She said it was important to her to be honest about her journey.

“I was on tour, so I had to go on stage and keep touring and I knew, it was like this big deep dark secret that I had to keep, which was a really strange feeling. And then I announced it on my Facebook, the day before my surgery, so I tried to be very open and honest and hopefully inspire people to go check themselves.”

Like Natasha, starting a family was a priority for Catherine.

“I had IVF in case I didn’t come out of menopause and then I went straight into chemotherapy for six months,” said Catherine.

“That was intense.

“Two types of chemotherapy. It was like three weekly for the first three months and then weekly for the last three months, and I got married in there somewhere, and then I had five weeks of radiation.”

As part of her breast cancer treatment, Catherine was offered goserelin and says she didn’t hesitate.

“It was offered to me before I started Chemo and it was a bit of a no brainer for me. I went for it straight away.”

“It was kind of scary. I didn’t know what going into menopause at 30 would be like. Now I know, it’s not fun.

“When I came out of it, the other side and got my period and I knew I could, I was going to be ok, and not long after fell pregnant. It was a pretty-special thing. I’ll never forget that.”

Catherine, like Natasha, didn’t expect to fall pregnant so quickly after treatment.

“I was actually booked in with my IVF doctor to see if everything was all good to go and should we start trying now.”

“I left it a month or two, I waited until my periods were sort of regular and then I had to cancel my appointment because I was pregnant.

“She called me and said ‘Oh my god, it’s a miracle baby. You fell so quickly’. We were very excited.”

How Catherine Benefited From Natasha’s Participation

Catherine appreciates that it’s because of women like Natasha, who have participated in clinical trials research, that her and husband James were able to have little baby Hank.

Catherine and Natasha were given the opportunity to meet and Catherine was able to share her gratitude for Natasha’s involvement in the POEMS clinical trial.

“I’m honestly grateful that she was so brave to do that. I can’t imagine going through all that and then also facing a trial, all this stuff, it would have been so scary and I just feel very proud of her and she’s obviously and amazing woman.”

“I’m really glad I got to meet her.”

Natasha says she encourages anyone who is offered a place on a clinical trial to consider it as it may help you, but also future generations of women and men diagnosed with breast cancer.

“Absolutely, I would recommend a clinical trial. It also helps you, but it also can help so many other people in the future,” said Natasha.

“It’s very exciting to know that something I was a part of, that Hank can be here and probably so many other babies.”

Breast Cancer Trials is the largest, independent, oncology clinical trials research group in Australia and New Zealand. We are committed to finding new and better treatments and prevention strategies for breast cancer through clinical trials research.

Breast Cancer Trials currently has a number open clinical trials. You can find out more at breastcancertrials.org.au or speak with your doctor to see if there is an open clinical trial that’s right for you.

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SAN ANTONIO BREAST CANCER SYMPOSIUM 2018

Every year, thousands of academic and private researchers and physicians from over 90 countries gather for a five-day breast cancer symposium in San Antonio, Texas.

SABCS 2018 Summary

Every year, thousands of academic and private researchers and physicians from over 90 countries gather for a five-day breast cancer symposium in San Antonio, Texas.

It’s an important conference for researchers who work in breast cancer, as it provides the latest research information from around the world, including breakthroughs in breast cancer clinical trials.

Several Breast Cancer Trials researchers were in attendance, including our Scientific Advisor, Dr Nick Zdenkowski. He sat down with us to provide a summary of the important research and announcements covered at the 2018 conference.

The Phase III KATHERINE Clinical Trial

The KATHERINE clinical trial was presented at the San Antonio Breast Cancer Symposium and simultaneously published in The New England Journal of Medicine. Dr Zdenkowski said the results garnered a lot of interest from those in attendance.

“It included patients with HER2 positive breast cancer who received neoadjuvant chemotherapy with trastuzumab or Herceptin. Some of these patients have a complete response, which means the treatment gets rid of all the cancer. They’ve got a really good prognosis. But for patients who don’t have a complete response, their prognosis is actually not very good.”

“What this trial did was randomly allocate patients to receive either ongoing Herceptin, which is standard of care, or T-DM1 which is a new HER2 targeted treatment, which we use for advanced HER2-positive breast cancer.”

Dr Zdenkowski said the results were very promising.

“They found the patients who received the new drug T-DM1, were less likely to experience a recurrent of their breast cancer in the future. There was actually a substantial and clinically important difference in the relapse rate; there was a reduced risk of developing invasive recurrence of the cancer or death by 50%. It’s something that, for a poor prognosis patient group, is really good to see.”

Many American based oncologists commented that they would immediately implement it in the clinic said Dr Zdenkowski, however Australia and New Zealand will have to wait.

“Because in Australia, firstly we need TGA approval. Secondly, we need PBS for the majority of patients, because it is an expensive drug. We can’t use it yet in Australia but hopefully it will come and ROCHE who make the drug will make the application.”

De-Escalation

Discussion and trials involving de-escalation have been occurring in Australia and New Zealand for quite some time. Dr Zdenkowski said it was good to see it was a large focus at the symposium.

“I was really interesting, because the US is a classic escalation situation. They always want to do more and more. We have got a couple of de-escalation trials, so it was quite useful to see that it’s breaking into the US market for trials like EXPERT. We had a trial in progress poster for the EXPERT trial, mainly to promote what we are doing and to show that we’re now starting to do trials on an international scale.”

He said a session on de-escalation, presented in a debate format and chaired by respected breast cancer researcher and clinician Eric Winer, was interesting.

“Debates can be difficult in medicine because there are always shades of grey. It needs to be fairly nuanced, but I think they did it well. The conclusion was, there are some patients who need more treatment like the KATHERINE study patients and there are some patients who need less, and we need to work out which patients they are. “

“There are patients, like TAILORx candidates, who would be considered for chemotherapy. But through the genomic test, they find out they are actually low or intermediate risk and therefore chemotherapy is not going to benefit them. This is similar to the EXPERT trial, for patients who are genomically low risk, we may find with that trial they don’t actually need radiotherapy.”

Dr Zdenkowski said the most difficult part of implementing de-escalation into patient’s treatment is communicating it to patients.

“Doing less is not something that patients take on that easily and oncologists probably need to think about how that is to be communicated to patients.”

Quality Of Life

Not all breast cancer research is focused on finding new treatments. Some researchers build on already existing treatments and prevention strategies to allow for a better quality of life for patients throughout their treatment and for years following. A number of quality of life researchers presented findings at San Antonio.

“There was a report about the quality of life benefits to breast conserving surgery. It showed that women who have a lumpectomy have a better quality of life than those who have a mastectomy. It’s symmetry (of the breasts), it’s not needing to think about having reconstruction later on.”

Another interesting quality of life study result presented was the use of a drug more commonly used for an overactive bladder to treat hot flashes.

“Women who have the most common type of breast cancer, hormone receptive positive breast cancer, almost always end up on some hormone blocking treatment and those hormone blocking treatments cause menopausal symptoms, hot flushes being the most significant one.”

“Hot flushes cause all sorts of secondary effects; breaks in concentration, sleep disturbance, worries about social events, alcohol can sometimes set it off, as can coffee, tea, chocolate and stress. Some women don’t want to go out in summer or out in public at all and that leads to some women stopping hormone blocking treatments which means their breast cancer is more likely to come back.”

“This research is looking at a new indication for a currently used drug called oxybutynin, which is used for problems with an overactive bladder. But it also has a potential affect on reducing hot flashes,” said Dr Zdenkowski.

“They found in the randomised trial that it did reduce the number and severity of menopausal hot flushes in women who are taking hormone blocking treatments like tamoxifen. It found oxybutynin was just as effective as many other drugs available for those symptoms. It has its own side effects, but it is an extra option for women.”

There was another quality of life study presented regarding the effects of exercise for patients during their chemotherapy treatment. It found for patients who exercise during their chemotherapy, their quality of life is better and fatigue levels returned to baseline after treatment. Disappointingly, it also found exercise has no effect on reducing the risk of breast cancer returning.

Immunotherapy

Immunotherapy is continuing to be a hot-topic in oncology and Breast Cancer Trials recently opened two new immunotherapy trials called CHARIOT and DIAmOND. At the 2018 ESMO conference in Munich, the IMpassion130 trial results were presented. IMpassion130 was for patients with triple negative metastatic breast cancer. Patients on the trial were given either nabpaclitaxel, which is chemotherapy and is currently standard care, or nabpaclitaxel plus atezolizumab, an immunotherapy drug. It was an important study as it was the first phase three trial to show the benefits of immunotherapy in triple negative breast cancer. Further analysis of this clinical trial was presented at San Antonio.

“This analysis was specifically looking at the PDL1 positive group as they were the ones to benefit. That’s the biomarker for this drug. The immune cells have a signal on the surface called PDL1, so if the immune cells have that signal then the treatment works. If they don’t, the treatment doesn’t work,” said Dr Zdenkowski.

“This was an exploratory analysis and needs to be confirmed in other studies, but it is promising to see.”

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Dr Nick Zdenkowski

Dr Nick Zdenkowski is the Breast Cancer Trials Medical Advisor, a Breast Cancer Trials researcher and Medical Oncologist.

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