FROM IVF TO BREAST CANCER: NAVIGATING A DIAGNOSIS IN EARLY MOTHERHOOD

We spoke with mum of two, Rebecca Pickering about her breast cancer diagnosis, navigating breast cancer and her participation on the OLIO clinical trial.

ā€œI’ve had a lot of IVF in the last couple of years, from 2020 to 2022. And then we had Dottie, and we also had Daphne through that time as well. So, after I had Dottie things started to change for me physically, which I stupidly overlooked and decided it was just hormone related from so much IVF.ā€

ā€œLeading up to the diagnosis, we were just finally medical free, like from IVF and everything, and I was working full time. The kids were happy, and I felt like we were coming into our boring 10 years of just raising a family and getting on with things. And I went to the doctors just to finally get my breast checked out and was diagnosed with breast cancer.ā€

ā€œThat first month that I was diagnosed where you are going through all the process of getting MRIs, biopsies, and trying to figure out what kind of cancer it is and if it had spread, it was pretty dark. It was emotional for me. I just shut down when, especially in a high-pressure situation like that.ā€

ā€œSo, I was concerned for me, and for my kids. It was hard because I wanted to be here to raise my kids. I wanted to see them grow up and I didn’t know if it had spread or not. Cancer is prevalent in our family, so I had hope. My mom had it 14 years ago and she’s still here and healthy and happy, so that was a good example.ā€

ā€œBut until you know that it hasn’t spread and it’s just a standard breast cancer, it’s not like your terminal or anything like that, just so much craziness goes in your head of what’s going to happen, how are you going to handle this, and everything like that.ā€

ā€œAnd answers don’t come quick enough, but you know, everything has a process. So, you do have to just wait. So, each week we’d get another little piece of the puzzle for about four weeks until we did the PET scan, and I got the confirmation that it hadn’t spread. And around that time we got confirmation that it was only stage two. So very lucky, considering I felt like I’d probably had an issue for nearly a year.ā€

Listen to the Podcast

We spoke with mum of two, Rebecca Pickering about her breast cancer diagnosis, navigating breast cancer with a young family, and her participation on the OLIO clinical trial.

How did your family react when you told them about your breast cancer diagnosis?

ā€œSo, my parents were away at the time, they were overseas. They didn’t know that I was going through the tests and everything. It was good timing. My mum and I are very close, so she would’ve been onto it if she hadn’t been here. So, it was nice that I just got to kind of process it in the lead up.ā€

ā€œAs soon as I had the mammogram, and the ultrasound, I knew something was wrong. Living in a small local town, the man that did my ultrasound had done all my ultrasounds. Not that I believe he remembered me or anything, but he immediately said to me ā€˜make sure you follow up with your doctor’. And it’s not something that he normally would say in that way.ā€

ā€œSo, my doctor has been my doctor for 14 years, and you just get a rapport with someone in that kind of relationship. The way my doctor rang, I immediately knew. The results weren’t just over the phone like they normally would be if it was nothing.ā€

ā€œWhen I saw him, he was nearly distraught that he had to tell me, because he was the one that told my mum as well, when she was diagnosed. My dad’s mum died of breast cancer when she was 38. So, he was quite like me, he just shut down and was essentially like ā€˜yep, let’s get on with this’, whereas my mum obviously broke down because she’s been through it and knew what I was about to head into.ā€

ā€œMy husband, Matt, was fine. He’s the same as me. Just a deer in headlights in this situation. Like, we’re just going to have to work through it. And obviously a lot of my family and friends were just devastated for me.ā€

ā€œI have two daughters and six nieces, and now that I know I have the BRCA gene in our family, you know my brother has it, so his daughter possibly has it. My daughters possibly have it. Any research towards the OLIO trial will benefit them in future years, I’m certain of that.ā€

What has your treatment been like so far?

ā€œThere are great local people in Mildura, but my doctor had felt that the Peter MacCallum Cancer Centre had never failed him. So, he referred me there, and my mum also went through the Peter MacCallum Centre, so it was where I wanted to be. I had my first appointment with oncologist around the end of October or start of November 2024.ā€

ā€œImmediately she knew that I might be interested in a clinical trial, because within five minutes of our first appointment, she mentioned the OLIO trial. So, I felt that the team thought I was a good candidate to be screened for the trial. Going back when I was diagnosed, I had promised myself I’ll do anything to fill my body full of whatever it needs, to get rid of cancer.ā€

ā€œSo, when my oncologist told me about the OLIO trial, I was all for it, as long as I got the same protocol. Because I didn’t know about trials. So how it works is, you get the same protocol as what everyone else gets and then some add-ons. So, we were keen straight away to get it done.ā€

ā€œFor participation in the trial, you had to get genetic testing for the BRCA gene. So, we did that, and I had to get a few blood tests to make sure my bloods were okay. That was a bit of an uphill battle. Some of my bloods weren’t coming back quite right at the end when we were so close to going on the trial. So, I just had to work on some blood tests and things like that, so we did all of that and I made the trial, which was good and the trial team are amazing.ā€

Why did you decide to participate in the OLIO clinical trial?

ā€œWhen my mum had breast cancer 14 years ago, there was no mention of the BRCA gene. So, in 14 years we’ve come so far already that they’ve been able to recognise that this gene is a problem for young women. So, when I went in to see Dr Sophie, I went into that appointment ready to have a mastectomy because I thought that’s what everyone around me was getting done.ā€

ā€œBut for this trial, we needed to do chemotherapy first. So, the plan was to start chemotherapy, and I did four rounds of that and then 12 rounds of paclitaxel as well as, as part of the OLIO trial. It is a chemotherapy tablet. And I also got immunotherapy as well. So, we’re just coming to the end of that phase now, and I booked in for a mastectomy in May.ā€

ā€œI feel lucky to be on the OLIO trial. The coordination behind the scenes from the team is great. It’s something I don’t have to think of. When I initially signed up for it, Dr Stephen Luen said to me that my life would now be organised by the ladies in the research team. And he was correct. Anything I needed, I would just go to that team, and they would organise it for me.ā€

ā€œEspecially appointment changes, because I live remotely, we’ve had to shuffle some appointments around, so I don’t have to come down to Melbourne as often. I asked the doctors the last time I was there if the OLIO trial and remote monitoring is open available through the Peter MacCallum Cancer Centre, or is it available everywhere? And they did say that it’ll hopefully start to be screened everywhere so that everyone will have the opportunity to be on this trial.ā€

ā€œI’ve known a few people with breast cancer that are going through it, or at the end of it now, and we discuss our different experiences, and I nearly don’t discuss some of the things that I’m doing as part of my treatment, because I do feel like you get a heightened level of care being on a trial, which is great for me, but everyone deserves it, if they can be on a trial.ā€

ā€œI have struggled so much with the side effects of chemotherapy, of the fatigue, the lack of motivation, the brain not functioning like it would normally do. I can normally make decisions very quickly. So anything to do with trials that are around treatment plans that may be improved, is so beneficial to anyone going through it.ā€

Why do you think ongoing research into breast cancer is important?

ā€œSo, I have a few reasons, which is that the survival rates are so much better now. When I talk to my oncologist team here, they say that the number of young women coming through is baffling and they’ve just noticed that trend that a lot of young women seem to be getting breast cancer.ā€

ā€œSo, for me, the trials are so important for the statistical rate, but also, it’s about the treatment plans for people. Anything where you don’t have to have chemotherapy or you don’t have to have the invasion of radiation or surgery is so good.ā€

There is a trial out at the moment, where they may not need chemotherapy (find out more about the OPTIMA clinical trial). So, to me that was important because chemotherapy has ruined me in a way that I never thought it would. I don’t know how people work with chemotherapy. I don’t know how they get through their life. I’ve worked full time and long hours for the last 10 years and I stopped working in December and honestly just lay on the couch most days.ā€

What are your plans for the future?

ā€œIn my mind I’ve got September as when I’m going to be clear of all this. I don’t know why it’s September. I have my surgery in May, and I don’t know if I’m having radiation yet. That’ll be decided after surgery. So, by September this year I hope to be finished with this. I know life will never go back to normal, like it used to be.ā€

ā€œI think there’s always going to be that cloud over you, and that concern about breast cancer coming back. But what I’m looking forward to is being cleared, and what I fear is it coming back somewhere else, because I don’t want chemotherapy again. I’ll do it, but it’s tough.ā€

ā€œWhat concerns me the most each day as I’ve been going through this, is my girls. Daphne is four. So, she knows something’s wrong. I’ve been in and out of hospital, I’m away getting treatment. I’m not working, which was a big part of our life was me working. She took a couple weeks to get used to me being home and then wanted to be home with me. She said to me yesterday that she hopes I’m sick forever because I’m home.ā€

ā€œSo, I do feel going forward, I need to be home more. It’s been something that’s played on my mind the whole time. You know, what do I want to learn from this and moving forward, how is our life going to look? And I do believe in time I’ll look at cutting back in my job and possibly seeing what else is around, in that avenue. So yes, it’s just been my family really.ā€

GIVE TO RESEARCH HELPING WOMEN LIKE ELISSA

Latest Articles

clarifying the role of her2-low in early breast cancer

Clarifying the Role of HER2-Low in Early Breast Cancer

early diagnosis and better treatments improve breast cancer outcomes
split-banner-image

Supportive Care

Supportive care is an important part of a patient’s journey through breast cancer and aims to improve their quality of life and overall wellbeing, both during and after treatment.

When someone is diagnosed with breast cancer, the focus goes beyond treating the disease itself. Supportive care plays an important role in looking after a patient’s physical, emotional, and mental wellbeing. It helps to manage symptoms, ease the side effects of treatment, and improve comfort throughout their treatment and recovery.

What’s the meaning of supportive care?

Supportive care refers to treatments and support that focus on improving an individual’s quality of life while they’re receiving care for breast cancer and after their treatment is complete.

What is often included in supportive care?

  • Help managing side effects like pain, nausea, or fatigue
  • Counselling and emotional support
  • Nutritional guidance and physical therapy
  • Support with hot flashes, hair loss, or body image changes

Breast Cancer Trials has conducted several clinical trials that have helped transform support to patients, including:

  • Preserving Fertility During Breast Cancer Treatment: The POEMS trial studied the use of goserelin to protect fertility during chemotherapy. It found that women who received goserelin were less likely to experience early menopause and had a higher chance of pregnancy after treatment.
  • Identifying Patients Who May Not Need Chemotherapy: The TAILORx trial showed that many women with hormone receptor-positive, HER2-negative, early-stage breast cancer could safely avoid chemotherapy, reducing unnecessary side effects.
  • Advancements in Surgery Reduction Techniques: The IBCSG-23 trial investigated whether patients with cancer in sentinel (or main) lymph nodes could avoid extensive lymph node removal. The study showed that less surgery did not affect survival and helped reduce side effects.

Breakthroughs like these are often referred to as treatment optimisation – making sure patients get the best possible outcome with the least possible side effects.

What is the role of supportive care in breast cancer?

Supportive care has become a central part of breast cancer treatment in Australia. Thanks to advances in research, survival rates for breast cancer have improved significantly over the last 30 years. During this time, research has broadened to not only include studies into improved treatments and preventions, but to also advance our knowledge in how to ensure that patients experience the best possible quality of life during and after treatment.

Clinical trials led by Breast Cancer Trials have improved supportive care by:

  • Reducing side effects,
  • Preserving fertility
  • Helping determine which patients can avoid chemotherapy or extensive surgery

Aspects of supportive care include:

  • Managing Treatment Side Effects: Addressing issues such as pain, fatigue, and nausea to help patients maintain daily activities and well-being.​ It can also help patients better tolerate treatment, meaning they are less likely to cease treatment
  • Providing Psychological and Emotional Support: Offering counselling and support services to help patients navigate the emotional challenges of a cancer diagnosis and the effects of treatment.​
  • Facilitating Physical Rehabilitation: Implementing exercise and rehabilitation programs to help manage side effects, restore physical function post-treatment and optimise general health.​

ā€œWhat I would love is for patients to have the best possible treatment that helps them live the longest but feel the best.ā€ — Dr Deme Karikios, Medical Oncologist, Nepean Hospital on quality of life outcomes and treatment success.

Supportive care is valuable at every stage of breast cancer, including:

  • At diagnosis: Offering clear information, counselling, ensuring psychological support and decision-making support.
  • During treamtent: Your medical team will develop a personalised treatment plan that not only includes treating your type and stage of breast cancer, but also aims to help you feel as well and function as well as possible during treatment. This includes addressing physical, psychological, emotional, social and financial effects of treatment. There are a range of support services available to patients outside of their treatment team, including:
  • After treatment: Assisting with rehabilitation, fear of recurrence, and ongoing wellbeing.

Symptom management: easing the burden of treatment

Supportive care aims to ease the physical and psychological effects of breast cancer and its treatment. These symptoms can be different for everyone. Some of the most common symptoms include:

  • Pain Management: Breast cancer therapy can cause discomfort for several reasons with treatment including both non pharmacological and pharmacological strategies to address the cause of the pain.
  • Nausea and fatigue management: Effectively managing nausea and fatigue can significantly improve overall well-being during treatment. Treatment related nausea predominantly occurs around the time of breast cancer treatment The PantoCIN study delivered encouraging results where Pantoprazole completely alleviated delayed chemotherapy-induced nausea and vomiting (CINV) in one out of eight participants, and the overall group reported reduced nausea.
  • Lymphoedema: Swelling in the arms or chest can occur after lymph node removal or the lymph nodes not working properly.
  • Hot flashes: Treatments that temporarily reduce oestrogen levels can trigger hot flashes. It’s also common for pre- and peri-menopausal women to enter premature menopause because of treatments like chemotherapy, which can also cause hot flashes.

Supportive treatment approaches

Supportive care utilises a holistic approach, focusing on:

  • Physical recovery
  • Emotional resilience
  • Nutrition
  • Mental well-being

These approaches make a real difference during treatment and throughout recovery.

Counselling and Psychological Support

Emotional and psychological support can be helpful during breast cancer treatment and recovery. There are various services available to assist with the mental and emotional challenges of breast cancer. For further information on resources, view our support services.

  • Body image, self-esteem and intimacy: Treatment can lead to significant changes in a patient’s body, which may impact body image, self-esteem, sexuality, intimacy, and relationships. Having access to a supportive network and professional guidance can provide valuable psychological support during this time.

Psychosocial Support

  • Psychosocial and peer support: Having access to a support system and being able to relate to others going through a similar experience, can help aid feelings of isolation and anxiety.

Nutritional Support

  • Dietary guidance during treatment: Maintaining a balanced, nourishing diet can help support energy levels, immune function, and recovery. A dietitian can provide personalised advice to manage changes in appetite, taste, or nutrient absorption caused by treatment.
  • Managing side effects related to digestion: Breast cancer treatment can cause appetite changes, constipation, or diarrhoea. Nutritional support plays a key role in addressing these symptoms, helping you stay as comfortable and well-nourished as possible throughout treatment.
  • The role of diet and exercise in breast cancer care: Maintaining a balanced diet and staying active are key to managing health during and after treatment. Together, they can help reduce side effects, support recovery, and improve long-term outcomes. To learn more about their impact, watch our Q&A video on the impact of diet and exercise in breast cancer care.

Physical Therapy and Rehabilitation

  • Physical exercise programs: Tailored exercise plans can help rebuild strength, improve mobility, and boost energy levels during and after treatment. Learn more about the benefits of physical exercise.
  • Encouraging participation in healthy lifestyle programs: As part of the Breast Cancer Trials Clinical Fellowship Program, Dr Cindy Tan is leading a project to better understand and improve how patients engage with diet and exercise programs after early-stage breast cancer treatment. The goal is to help more patients access and stick with lifestyle changes that support long-term health. Learn more about this research.
  • Rehabilitation for side effects: Physical therapy and rehabilitation play an important role in recovery following procedures like sentinel lymph node biopsy or axillary clearance than can cause side effects like cording after breast cancer. Rehabilitation can help improve shoulder and arm movement, reduce stiffness, and support the body’s healing process.

Is supportive care the same as palliative care?

This is a common question. While supportive care and palliative care both aim to improve comfort and quality of life, they are applied in different ways:

  • Supportive care is useful at any stage of breast cancer, starting from the moment of diagnosis. It helps manage symptoms, support physical and emotional health, and improve overall wellbeing throughout treatment.
  • Palliative care is more commonly associated with advanced or metastatic breast cancer. It focuses on easing pain and other symptoms when a cure is not possible, ensuring the patient remains as comfortable as possible. It also provides emotional and spiritual support for both the patient and their family.

Both types of care are important for managing symptoms and improving the patient’s quality of life.

The role of clinical trials in advancing supportive care

Supportive care is an important area of breast cancer research. While much of the focus is on treating the cancer itself, there is also significant research aimed at improving patients’ wellbeing and reducing the impact of treatment. Areas that are being explored or may be investigated in future research include:

  • Symptom management: Investigating better ways to manage breast cancer fatigue, pain, nausea, and hot flashes, helping patients stay comfortable during treatment.
  • Measuring quality of life and general well-being: Conducting trials that measure how treatment side effects, such as fertility changes and chemotherapy symptoms, affect daily life is important for understanding where there are gaps in supportive care, and how interventions can be designed to improve quality of life and general well-being.
  • Genetic and personalised supportive care: Investigating how genetics impact responses to treatments, aiming to provide more tailored treatment and prevention with fewer side effects.
    • The OlympiA Trial found that administering Olaparib tablets twice daily for one year, following local treatment then standard chemotherapy, improved overall survival rates in patients with BRCA1 or BRCA2 mutations.
    • The BRCA-P Trial is an ongoing study evaluating the effectiveness of the drug Denosumab in reducing or preventing the risk of breast cancer in women with a BRCA1 gene mutation.

Why is supportive care research so important?

Supportive care is important because it focuses on the person as a whole—not just the breast cancer. It addresses the emotional, social, and physical challenges that come with treatment and recovery.

While the primary goal of breast cancer treatment is to manage the disease, the experience of living with breast cancer is equally significant. Supportive care ensures that individuals stay well, informed, and connected throughout their journey, helping them cope with the side effects and emotional toll of treatment.

Research in supportive care is just as important as discovering new treatments for breast cancer itself, as it aims to improve quality of life and the overall experience for those affected by the disease.

Donate today to support research that enhances the quality of life for those undergoing breast cancer treatment.

HELP CHANGE LIVES THROUGH BREAST CANCER TRIALS RESEARCH

Latest Articles

clarifying the role of her2-low in early breast cancer

Clarifying the Role of HER2-Low in Early Breast Cancer

early diagnosis and better treatments improve breast cancer outcomes
split-banner-image

What Does A Breast Cancer Lump Feel Like?

Learn from Breast Cancer Trials what a breast cancer lump feels like, how to identify it, and when to seek medical advice.

Breast cancer can be an overwhelming diagnosis; however, early detection plays a crucial role in improving outcomes and treatment success.

A question that is often asked, is Understanding what a cancer lump feels like can help in the early recognition of breast cancer. By becoming familiar with the typical characteristics of a breast cancer lump, you may be able to detect it earlier, which can lead to quicker diagnosis and more effective treatment options.

While not every lump in the breast is cancerous, knowing what to look for can help guide your next steps. If you discover a lump or any new unusual changes, it’s important to follow Cancer Australia’s guidelines and seek professional medical advice.

What is a breast lump?

A breast cancer lump typically presents with certain characteristics that may help differentiate it from other types of lumps. Understanding what a breast cancer lump feels like to touch is the first step in recognising potential issues. Common traits of a breast cancer lump include:

  • Hard or firm texture: A cancerous lump is often firm or hard to the touch.
  • Irregular shape: It may not be round or smooth; instead, it could feel uneven or jagged. It’s important to know your ā€˜normal’ shape to help monitor irregular changes.
  • Fixed (not easily movable): Cancerous lumps are usually fixed in place and don’t move under the skin when touched.
  • Painless in most cases: Most breast cancer lumps are painless, though some people may experience mild discomfort.
  • Located in various areas: The lump may be in the breast or even in the underarm region.

Beyond the lump itself, there are several other signs and symptoms of breast cancer to be aware of:

breast cancer skin changes pictures. it's important to see your doctor if you notice any changes to the skin on or around your breast.

For examples of skin texture changes and additional symptoms, view our article on breast cancer skin changes here.

It’s also important to consider other symptoms that may suggest breast cancer. Its common (and normal) for one breast to be slightly bigger than another. However, if you notice unevenness, a new skin rash or raised plaques on the breast, or a nipple that used to point out is now pulling in or retracting, it is recommended to seek professional medical advice. For more details on non-lump symptoms, you can refer to our breast cancer symptoms article.

Tamara’s Diagnosis and The Importance of Clinical Trials

Tamara Dawes was a participant in a clinical trial conducted by Breast Cancer Trials. Tamara discovered a lump due to her proactive approach to health checks and seeking medical advice when she noticed an unusual lump in her breast. Her decision to participate in a clinical trial was motivated by the opportunity to contribute to research and strengthen the data supporting future treatments. Tamara’s involvement was influenced by her desire to support the advancement of breast cancer treatments and help improve the side effects associated with treatments.

What to do if you find a lump in your breast?

If you discover a lump in your breast, it’s normal to feel concerned. However, it’s important not to panic. Here are the key steps you should follow:

  1. Monitor: Monitor the lump you have found 3-4 weeks to see whether it changes.
  2. Consult a doctor: Book a consult with your doctor and they will assess the lump to determine the next steps.
  3. Imaging: Your doctor may recommend imaging tests, such as a mammogram or ultrasound, to get a clearer picture of the lump.
  4. Biopsy: In some cases, a biopsy may be needed to confirm whether the lump is cancerous.

It’s important to remember that not all lumps are cancerous. In fact, many lumps are benign. However, it’s always best to seek a medical opinion when you notice unusual changes.

Breast cancer treatment and support

If diagnosed with breast cancer, there are several treatment options available, depending on the stage and type of cancer. These may include:

  • Surgery: Often, surgery is required to remove the tumour or even the entire breast in more advanced cases.
  • Radiation: This treatment uses x-rays to target and destroy cancer cells.
  • Chemotherapy: Chemotherapy involves using medications to kill cancer cells or stop their growth.
  • Targeted therapy: This treatment targets specific molecules involved in cancer cell growth, offering a more tailored approach to treatment.
  • Clinical trials: If eligible, your doctor may recommend participation in a clinical trial. Clinical trials are vital for advancing medical knowledge and discovering new treatments. Learn more about our open trials.

There are also numerous support resources available for those affected by breast cancer. From counselling services to support groups, there are ways to help manage the emotional and physical challenges that come with a diagnosis.

For more information on available resources, visit our resources for patients and families page.

Understanding what a breast cancer lump feels like can save lives

Recognising what a breast cancer lump feels like and noticing unusual changes in your breasts are important steps in improving the chances of early detection and successful treatment if breast cancer is diagnosed.

Cancer Australia recommends women of all ages to be aware of how their breasts look and feel, and to seek professional medical advice if anything unusual appears. Women aged 50-74 are invited to screen every two years and women over the age of 40 and 75 are welcome to screen, however a consult with a medical professional is advised.

You can help fund critical breast cancer research by donating to support continued advancements in early detection and treatments. Every contribution helps us ensure that no more lives are cut short by breast cancer.

Participation in our open clinical trials is critical for advancing medical knowledge and improving treatment options. Learn more about our current clinical trials programs.

FAQs

What is the most appropriate method for early detection?

The most appropriate methods for early detection of breast cancer include:

  1. Breast awareness: This involves being familiar with the normal look and feel of your breasts so that you can notice any abnormal changes.
  2. Clinical breast examination: A physical examination of the breasts by a healthcare professional to check for abnormalities.
  3. Screening mammography: Regular mammograms for women aged 50-74 through BreastScreen Australia, the national screening program.

For more on these methods, check out Cancer Australia’s early detection resources.

What are the key warning signs of breast cancer?

Key warning signs of breast cancer include:

  • A lump in the breast
  • Nipple discharge
  • Skin dimpling
  • Changes in breast size or shape

For more details, visit our symptoms page.

What does stage 1 breast cancer feel like?

Stage 1 breast cancer is often characterised by a small, firm, and painless lump in the breast. It may not cause noticeable symptoms but can be detected by medical screening. For more information on the stages of breast cancer, visit our breast cancer stages page.

Can men have breast lumps?

Yes, men can develop breast cancer, although it is rare compared to women. Breast cancer in men accounts for less than 1% of all breast cancers. Men may experience similar symptoms to women, such as a lump in breast or changes in the skin. For more information on male breast cancer, including statistics and symptoms, visit our male breast cancer page.

Latest Articles

clarifying the role of her2-low in early breast cancer

Clarifying the Role of HER2-Low in Early Breast Cancer

early diagnosis and better treatments improve breast cancer outcomes

BEYOND THE PLATE: REBUILDING HEALTHY HABITS AFTER BREAST CANCER

Dr Cindy Tan is a 2025 clinical fellow with Breast Cancer Trials, and her project is looking to understand the barriers and enablers of breast cancer survivors to join a lifestyle intervention.

Lifestyle interventions such as diet and exercise have been shown to have positive impacts on clinical outcomes, including tolerance to chemotherapy, fatigue, weight maintenance, and reduce the risk of cancer recurrence. However, there is no one intervention that fits all. Maintaining healthy lifestyle activities can be challenging for some, and reasons for non-adherence vary.

Therefore, it is important to understand the barriers and enablers of breast cancer survivors to join a lifestyle intervention. Dr Cindy Tan is a 2025 Clinical Fellow with Breast Cancer Trials, and we spoke to her about exploring breast cancer survivors’ preferences for healthy diet interventions and determining barriers for participation.

ā€œMy name is Cindy Tan; I’m a senior clinical dietician attached to the Sydney Cancer Survivorship Team. My main role is to see patients after they have completed their anti-cancer treatments and with other clinicians, like exercise physiologists, nurses, medical oncologists, and psychologists trying to provide the education or information for them to improve their quality of life, and reduce the risk of cancer recurrence as well as, manage their symptoms.ā€

ā€œSo that’s my main role, and my other role is a Research Fellow at University of Sydney. I think it’s important to be seeing patients and knowing that my input can benefit them is beneficial, and while some of them don’t want to talk about diet, most people appreciate the input, so I think that’s very rewarding.ā€

ā€œMy current role is to see patients after they have completed their anti-cancer treatments. The goal is really to provide dietary information for them to improve their diet quality if required, because some of them are doing very well, but also reduce the risk of cancer recurrence, working on those lifestyle risk factors. So, I work with a range of clinicians like exercise physiologists, psychologists, nurses and medical oncologists, where the idea is really to provide holistic input to patients.ā€

Listen to the Podcast

Dr Cindy Tan is a 2025 clinical fellow with Breast Cancer Trials, and her project is looking to understand the barriers and enablers of breast cancer survivors to join a lifestyle intervention.Ā 

Can you provide an overview of your research project and what inspired you to pursue this topic?

ā€œI’m a clinical dietician, so I normally see patients at the end of their treatments. So, during this period, we know that they have often had a very tough time during the treatments and are dealing with lots of side effects. There is also obviously a disruption to their life, especially for breast cancer patients.ā€

ā€œWe conducted a survey and 50% of patients that we saw have made some dietary changes after the cancer diagnosis. Some of them were aligned with dietary guidelines that we provided, however some of the changes were less than ideal. And we found that people were becoming more physically inactive, for various reasons. This can be because of a changing lifestyle and obviously fatigue is one of the common side effects from the treatments.ā€

ā€œWe know that healthy eating by exercise and weight gain is one of the lifestyle risk factors for cancer recurrence or cancer risk. So, for that reason, we are always trying to address them at the end of their treatment, but we know that health behaviors take some time to adopt, so I guess that’s a reason in my research role where I was able to get a philanthropic grant from the University of Sydney to run a phase two feasibility study. So basically, it’s really trying to deliver healthy eating information and offer exercise sessions to a group of women during their chemotherapy and bringing those interventions forward rather than trying to address them at the end.ā€

ā€œSo, from these studies, we see that they have a very good uptake. We have a lot of interest from the clinicians and among those people who are eligible for this study, 97% of them say that they are interested and that they want to take part, but unfortunately during this time many participants drop out as well.ā€

ā€œThe dropout rate is a lot higher than what we anticipated compared to these lifestyle intervention studies. They usually do it after, when people finish treatments and things, and so the dropout rate is higher. That’s why I’m hoping that this project will allow me to explore the women who are interested in these lifestyle interventions, and sort of what time point it could be. From a clinician point of view, I think early intervention is better.ā€

“We know exercise helps with fatigue. We know healthy eating can have other health benefits. So, for that reason, I guess that we just want to explore the reasons people find that they can’t continue with the study, and on the opposite hand what are the reasons that make them continue with the study. So, this is where the project is about.ā€

How are you structuring this study? What methods are you going to use to collect the data?

So, what we are planning to do is to survey a group of women with breast cancer, or early-stage breast cancer. So, asking them a few questions through this online survey to see whether they’re interested because sometimes it’s hard if people are not interested in lifestyle interventions.ā€

ā€œIt doesn’t matter what we do, but we know that the research has shown that usually people are interested. I guess another key question we are wanting to answer is what makes people participate in the study? And likewise, what are the reasons that they can’t participate, for example time commitments particularly for younger patients.ā€

ā€œThis would mean we have to then alter our study design to suit it, but at this point we are really fathering the information through the online survey and whoever is interested, I would like to explore more in-depth information through the interview.ā€

ā€œSo that’s my goal, and I think Breast Cancer Trials have a very good network of consumers involved as well. So, I’m hoping that this online survey can be distributed through the relevant Breast Cancer Trials networks as well.ā€

What criteria are you using to select patients for the study?

ā€œWe want to make it broad. So, at this point we are really targeting towards women with early-stage breast cancer, and certainly we’re open to men’s as well, but they’re usually quite a minority group. And when we look at the enablers and barriers, obviously there’s always some sort of a difference between male and female.ā€

ā€œSo, because of the time and the resources at this point we’re targeting towards early-stage breast cancer, if possible. I also would like to translate that into a different language so that we can start looking at the patients from other linguistic and diverse backgrounds.ā€

Have you identified any early trends or themes in your research so far?

ā€œSo, when we did our lifestyle intervention studies there are exercise and diet interventions delivered to the breast cancer patients, through online virtual platforms and what we noticed is that many of them like the study. So, they’re interested, and they jump at the opportunity and say that they like the design and want to participate.ā€

ā€œBut when it comes to completing the baseline assessment and actually attending the sessions many of those who drop out say that they have a lot of time commitments and competing interests in a sense, not just regarding medical appointments, but also family commitments, and work commitments, because some of them are still working full time.ā€

ā€œSo, I think the biggest thing is recognising commitments people have outside of their medical appointments, which makes participating in the program quite difficult. In saying that though, I think some people also say that they really like the online or virtual platform, which means they can join anytime from wherever they’re comfortable.ā€

ā€œSome of them use their lunchtime hours or break to join. So that virtual platform actually allows them to have that flexibility. And traditionally, we can only offer lifestyle interventions, or just a diet intervention by itself, or education face-to-face on hospital grounds. And we know that it is hard to travel to the hospital, and one of the common barriers reported by people is parking, we know it is always challenging to find a park at the hospital.ā€

ā€œSo, I think that allows them to have flexibility in that way. They also like the peer-support virtual platform, you can see the people and the group actually going through the treatment together. And I guess that’s one of the reasons for those who stay on because they like that more social component.ā€

ā€œThere’s no one lifestyle intervention fits everyone. So, I guess this is where we want to find out what the barriers are. One of the other common barriers from participants is that they feel a little bit overwhelmed, with lots of things going on.ā€

ā€œThe cancer diagnosis, the whole adjustment to the chemotherapy, having to stop work. So, I think that it is a big, major life event, so it’s understandable. So, we also want to know whether the time during chemotherapy is actually not a good time for people to participate, or maybe we need to adjust the study design and how we deliver the interventions so that it suits people or encourages them to participate. So that is the other common barrier that we hear from patients is the emotional overwhelm, as well as the time commitment.ā€

What are some of the most significant barriers in preventing breast cancer survivors from joining diet interventions?

ā€œI’m using the recent study as an example because some of the things that people really like about it is the peer supervision component. They also like the fact that they’re being held accountable, so in the sense that they know they need to attend.ā€

ā€œAnd within this program, one of the design elements is education around diet and exercise and encouraging people to keep up with their normal routines. As well as reminding them that healthy eating is important, and exercise is important. So, they like the weekly sessions where they see others going through the same things as them. Peer support is crucial.ā€

ā€œPut it this way, everyone knows the healthy eating and diet message, its not new information, and many of our breast cancer ladies are eating quite well and were fit to begin with, but just because of the fatigue and change in lifestyle, they result in people not keeping up with what they were doing before.ā€

How do you think healthcare providers can help to bridge the gap between survivors and lifestyle programs?

ā€œI certainly think that healthcare professionals, especially medical oncologists, radiation oncologists or surgeons, have a crucial role in this. As I mentioned earlier, these studies have a very good uptake, partly because we have a lot of buy-in from the clinicians, and so they encourage their patients to join the program.ā€

ā€œThe encouragement from the clinicians makes a huge difference in recruitment. So, because of that reason, we managed to finish our recruitment three months ahead of schedule, which is unlike other studies. So, I think that is where the role of the health professionals comes in and is important.ā€

ā€œI think health professionals are in the positions where they can provide appropriate information and guide the patients to the appropriate resources to seek information because we know Dr Google has a lot of dietary information. Some of this information can be quite reliable if it comes from a reliable source, but a lot of information is not appropriate.ā€

ā€œSo, I guess that having clinicians be the people to direct patients to the appropriate resources to seek information will be crucial. Especially as many of them want to make changes to their lifestyle after a cancer diagnosis.ā€

How do you hope your research will influence future diet interventions for breast cancer survivors?

ā€œI’m hoping that through this project we gather data that will help us to inform a phase three study, to look at what will be the best way to deliver lifestyle interventions in terms of diet and exercise. They always come hand in hand and certainly, from a clinical point of view I’m also hoping that it will inform the clinicians on how they can best support our breast cancer patients with early-stage disease, to seek information.ā€

ā€œLike healthy eating and exercise, not everyone is ready to take part in the lifestyle intervention programs. That’s where we just want to know if they’re not ready, what can we do to support them? Obviously if we have a program, then we can refer them on to that.ā€

What are the next steps after this research is completed?

ā€œI’m hoping that this data will help us to inform our phase three studies and the data can be used to build a clinical pathway, as well.ā€

ā€œWe know many breast cancer patients with early-stage cancer survive the cancer, but they have a lot of other comorbidities. So, we need to look at bone health and need to look at cardiovascular disease, and those sorts of risk factors at late-stage breast cancer.ā€

ā€œSo, one of the key things is about healthy eating and exercise. That’s why they’re important because these are the modifiable lifestyle risk factors and everyone kind of knows about it. That’s why they want to make changes. So, the whole idea is really to encourage people to be more active. And what we are aiming for is not just improving the health benefits in terms of health status, but also to reduce the risk of cancer recurrence.ā€

ā€œOn top of that we are focusing on quality of life as well. Research has shown that exercise can help with symptom management. And when people get fitter, they have the energy to do the things that they want to do. We know that healthy eating makes people feel better and certainly can help with weight management.ā€

ā€œWe all know that they can link to better health outcomes, and that’s why overall women do report that they feel better. So, I think that’s part of the quality of life that we really want to focus on, not just about the health outcome itself.ā€

Support Breast Cancer Research

Latest Articles

clarifying the role of her2-low in early breast cancer

Clarifying the Role of HER2-Low in Early Breast Cancer

early diagnosis and better treatments improve breast cancer outcomes
split-banner-image

Managing Cording After Breast Cancer

Learn about breast cancer cording, its causes, symptoms, and treatments. Get expert advice on managing pain, exercises, and recovery after surgery.

Breast Cancer Trials is dedicated to improving the lives of those affected by breast cancer. Through research and education, we help people better manage side effects and improve recovery. One such side effect that can occur after breast cancer surgery is cording.

Cording (also known as axillary web syndrome) can be an unexpected part of recovery, but with the right care, it can be managed effectively. Here’s what you need to know about breast cancer cording.

What is cording in breast cancer?

Cording, also known as axillary web syndrome, is a condition that can develop after breast cancer surgery, especially following lymph node removal or mastectomy. It’s characterised by the formation of tight, rope-like bands of tissue under the skin, most commonly around the underarm area.

under arrm cording breast cancer side effect | 1

Is cording, a sign of breast cancer? The answer is no, cording after breast cancer surgery is a typical side effect and is not an indication that the cancer has returned. It occurs due to disruption of the lymphatic system during surgery, which can cause the formation of these tight tissue bands.

Importantly, cording can appear anywhere from a few weeks to several months after surgery. While it can be uncomfortable, the good news is that cording is usually temporary. Its duration can vary, but with the right treatment and care, it is manageable and can improve significantly.

How painful is cording?

The pain associated with cording can vary depending on its severity. For some individuals, it may feel like mild tightness, while others may experience sharper pain, especially when attempting to move their arm or shoulder.

Cording can also impact your range of motion, making everyday activities such as dressing, lifting objects, or reaching overhead more difficult.

An important consideration is the link between cording and lymphoedema, which causes swelling in the arm, hand, or chest. While cording and lymphoedema share some overlapping symptoms, they are distinct conditions. Cording involves the tightening of tissue, often forming rope-like bands under the skin, while lymphoedema typically presents as swelling or a feeling of heaviness in the affected areas.

Despite their differences, both conditions can affect the arm and shoulder, leading to discomfort, restricted movement, and reduced mobility. It’s also possible for someone with cording to develop lymphedema at the same time, as both can result from disruption in the lymphatic system during surgery.

If you notice symptoms like swelling, a sensation of heaviness, or any other unusual changes along with cording, it’s important to speak to your doctor. They can help you determine if the symptoms are related to lymphedema and suggest the best course of treatment.

How do you get rid of cording?

The good news is that cording after breast cancer surgery can often be treated effectively with a combination of therapies. The key to improving mobility and reducing pain is to keep your joints and tissues mobile. Early rehabilitation and movement therapy are critical in breaking down the tight bands of tissue and helping to restore full range of motion to the affected arm.

Here are a few tips to help alleviate cording:

  • Movement: Regular movement of the arms and shoulders is essential to keep muscles and tissues flexible, reducing the tightness associated with cording.
  • Stretching exercises and physiotherapy: These play an important role in loosening the tissue and easing the discomfort. A physiotherapist can guide you through the best exercises for cording after breast cancer surgery to relieve tightness and improve flexibility.
  • Massage therapy: Specialised techniques can help break down the tight bands of tissue and relieve the discomfort associated with cording.
Naveena, a breast cancer patient,Ā shared her journey with triple-negative breast cancer and the side effectsĀ she faced on our podcast. She recalls, “I couldn’t lift my arm past my shoulder. Apparently, that’s called cording, and I had to see a specialist physiotherapistā€.

In most cases, cording rarely returns once it’s properly treated. However, if you notice that the cording persists or worsens despite these efforts, it’s important to consult a healthcare provider for a more tailored treatment plan.

Should you be concerned about breast cancer recurrence?

It’s important to understand that cording after breast cancer surgery is not a sign of breast cancer recurrence. While cording can be uncomfortable and may cause concern, it is typically a temporary condition related to the surgical process, not a sign that the cancer has returned.

That said, regular screenings and follow-up check-ups are essential to monitor your recovery and ensure any potential issues are detected early. If you notice any unusual changes in your body or if you have concerns, don’t hesitate to reach out to your healthcare team.

For further support on managing fears related to breast cancer recurrence, you can read our blog: Easing the fear of breast cancer recurrence.

Breast Cancer Trials’ role in advancing breast cancer research and treatment

Breast Cancer Trials is at the forefront of advancing breast cancer research and improving the well-being of individuals affected by breast cancer. Breast Cancer Trials conduct clinical trials to test new and more effective treatments for managing the side effects of breast cancer treatment, as well as enhancing overall recovery.

If you’re interested in learning more about clinical trials, explore our current open trials.

To support our ongoing efforts, we encourage you to donate to support breast cancer research.

FAQs about breast cancer related cording

What are the early signs of cording?

One of the early signs of underarm cording breast cancer patients may experience is the appearance of visible or palpable tight cords under the skin, typically in the underarm. These cords may appear as one thick band or as several smaller, tighter bands running along the skin. In some cases, the cords can be felt as you move your arm or even when gently pressed on.

As well as the visual signs, you may experience some discomfort or a pulling sensation, especially when raising your arm or reaching. Cording can limit your arms range of motion and make everyday tasks like dressing or lifting objects more challenging.

If you notice any of these early signs, it’s important to consult a healthcare professional to help manage and treat cording early on.

How do you get rid of cording?

The most common ways to treat cording is through physiotherapy, specialised massage techniques, and stretching exercises. If you’re unsure about what’s best for you, it’s always a good idea to consult with a healthcare professional.

Does cording (axillary web syndrome) mean I have cancer?

No, cording does not mean that you have cancer. It’s a common side effect of breast cancer surgery, especially after lymph node removal, and is not a sign of cancer returning.

What is lymphatic drainage therapy after breast cancer?

Lymphatic drainage is a type of massage therapy designed to improve the flow of lymph fluid, reduce swelling, and manage conditions like lymphedema. It’s especially useful for people who have had breast cancer surgery or lymph node removal.

What are the symptoms of lymphoedema in breast cancer patients?

Symptoms of lymphoedema include swelling in the arm, chest, or hand, as well as feelings of heaviness, tightness, or aching. Early intervention and treatment can help prevent complications such as infections.

Can you experience cording without breast cancer?

Yes, although cording is mostly associated with breast cancer surgery, it can also happen in people without breast cancer. This can occur due to other surgeries, infections, or trauma to the lymphatic system.

If you’re dealing with cording after breast cancer, don’t hesitate to seek out support, whether that’s through physiotherapy, massage, or other treatments.

Support Us

Help us to change lives through breast cancer clinical trials research

Latest Articles

clarifying the role of her2-low in early breast cancer

Clarifying the Role of HER2-Low in Early Breast Cancer

early diagnosis and better treatments improve breast cancer outcomes
split-banner-image

Can a Breast Cyst Turn Out to Be Cancer?

Learn about breast cyst misdiagnosis and the odds of breast cancer.

For many women, the worry that a breast cyst may turn out to be cancer can be overwhelming. However, it’s important to understand that breast cysts are generally non-cancerous and rarely develop into cancer.

While it’s highly unlikely for a breast cyst to become cancerous, breast cancer can sometimes be misdiagnosed as a breast cyst, especially when the lump appears complex or has unusual characteristics when it is scanned using ultrasound or with other types of imaging. This is why it’s crucial to get any unusual lumps checked by a healthcare professional and to follow up with further tests if necessary.

What is a breast cyst?

A breast cyst is a fluid-filled sac that forms in the breast tissue. These cysts are common and usually non-cancerous. Women aged 35-50 are most likely to experience breast cysts, although they can occur at any age.

Breast cysts may feel like smooth, round lumps, and they can be tender, particularly around your menstrual cycle. They’re generally benign, meaning non-cancerous, but it’s still important to get them checked.

A breast cyst may also be completely asymptomatic, and therefore unable to be felt. They are diagnosed with ultrasound or other types of medical imaging.

For those at higher risk of breast cancer without any symptoms (like a lump), tools like iPrevent can be helpful in assessing your personal risk and deciding when to seek screening.

Heidi’s Story

Heidi’s experience began during a routine check-up after a friend was diagnosed with breast cancer in her early 40s. With free mammograms available every two years for women aged 40 and over, it is recommended that women between the ages of 50-74 be proactive and schedule a free mammogram. Women under 40 can also book a mammogram, but it will be a paid service based on a consultation with their doctor.

Her story reinforces the need for vigilance and proactive health checks, particularly when something doesn’t feel right.

Can a cyst in your breast turn into breast cancer?

One of the biggest concerns women have is: Can a cyst in your breast turn into breast cancer? The simple answer is no. Breast cysts are benign and do not turn into breast cancer.

That’s why it’s important to be diligent about checking any breast changes. If you have a lump that you believe is a cyst, especially one that feels different or has grown, it’s essential to have it checked out. Ā Tools like iPrevent can be helpful in assessing your personal risk and deciding when to seek screening.

While breast cysts are no more likely to turn into breast cancer than any other part of the breast, if you’re at higher risk of developing breast cancer, it’s always a good idea to get an assessment from your doctor.

Can a cyst turn out to be cancer?

A simple cyst will not turn into cancer. If there are unusual features such as those seen in a complex cyst, further tests may be required, and the opinion of a medical professional is highly recommended.

While most breast cysts are benign and not cancerous, it’s understandable to wonder if a cyst can turn out to be cancer. Diagnostic tools like mammograms, ultrasounds and in some cases, biopsies, help doctors determine whether a cyst is benign or cancerous.

It’s important to remember that breast cysts themselves do not turn into cancer, but in certain cases, further testing may be required to rule out breast cancer. If a cyst changes in size, shape, or texture, it should always be re-evaluated by a medical professional.

Can breast cancer be misdiagnosed as a cyst?

Breast cancer can sometimes be misdiagnosed as a cyst, especially when a lump has characteristics that mimic a breast cyst. Complex cysts, which have both fluid and solid components, may look similar to cancerous lumps on imaging tests.

What are the odds of a comples breast cyst being cancerous?

Certain types of breast cancer, such as invasive lobular carcinoma, can sometimes be mistaken for a breast cyst, particularly when the cyst is complex.

Imaging techniques such as mammograms, ultrasounds, and MRIs play an important role in helping to avoid misdiagnosis. While complex breast cysts can raise concerns, it’s important to remember that most of them are benign.

Though complex breast cysts are often non-cancerous, the role of medical research is essential in improving diagnostic accuracy. Breast cancer can sometimes be misdiagnosed as a cyst, especially if the cyst changes in size, shape, or feel, but this is very rare.

Ongoing medical research and advances in imaging technology continue to improve our understanding of such cases. It’s important to follow up with your healthcare provider for appropriate tests and evaluations.

References:

  1. Health.com: Can breast cancer be misdiagnosed as a cyst? (https://www.health.com/condition/breast-cancer/doctors-misdiagnosed-the-lump-in-my-breast-and-it-turned-out-to-be-stage-3-breast-cancer)

Support Us

Help us to change lives through breast cancer clinical trials research

Latest Articles

clarifying the role of her2-low in early breast cancer

Clarifying the Role of HER2-Low in Early Breast Cancer

early diagnosis and better treatments improve breast cancer outcomes
split-banner-image

Triple-Positive Breast Cancer

Learn about triple-positive breast cancer, its prognosis, recurrence, treatment options, genetic and hereditary factors, and research updates.

What is triple-positive breast cancer?

Triple-positive breast cancer is a subtype of breast cancer that accounts for about 10% of all breast cancer diagnoses. It is characterised by the presence of three key protein receptors on or within the cancer cells:

  1. Oestrogen receptor (ER)
  2. Progesterone receptor (PR)
  3. Human epidermal growth factor receptor (HER2)

These receptors play a significant role in the growth and behaviour of this subtype of breast cancer. When these proteins are present, the tumour cells may be more sensitive to certain types of treatment.

Characteristics of triple-positive breast cancer receptors

  • Oestrogen receptor (ER) positive: The oestrogen receptor is a protein found on certain breast cancer cells. When oestrogen, a hormone, attaches to this receptor, it signals the cancer cell to grow.
  • Progesterone receptor (PR) positive: The progesterone receptor is another protein found on certain breast cancer cells. The progesterone receptor works with the oestrogen receptor to fuel cancer cell growth.
  • HER2-positive: HER2-positive means the cancer cells have an abnormally high number of HER2 genes, resulting in an overproduction of the HER2 protein on the surface of the cell. This also fuels cancer cell growth.

How it differs from other types of breast cancer

Triple-positive breast cancer is a subtype that has all three key receptors: oestrogen receptors (ER), progesterone receptors (PR), and the HER2 receptors. These proteins can be targeted with treatments to help stop the growth and division of these breast cancer cells. On the other hand, triple-negative breast cancer lacks all three proteins, making it harder to treat.

Additionally, HER2-negative breast cancers do not overexpress the HER2 gene or receptor.

Triple-positive breast cancer treatment

Treatment for triple-positive breast cancer is often a multi-pronged approach, incorporating several types of therapy. These treatments are designed to target the specific receptors and characteristics of the breast cancer, offering the best chance for a favourable outcome.

Standard treatment options

Because triple-positive breast cancer has all three proteins, it can be treated effectively with a range of therapies, including:

  • Hormone therapy: Medications such as tamoxifen or aromatase inhibitors are used to block the action of oestrogen or lower its levels in the body.
  • HER2-targeted therapy: Drugs like trastuzumab (Herceptin) and pertuzumab (Perjeta) specifically target the HER2 receptor, stopping the breast cancer cells from growing.
  • Chemotherapy: Chemotherapy may be used for tumours to reduce the risk of the cancer returning and spreading, or when targeted treatments may not be sufficient.
  • Surgery and radiation therapy: For localised breast cancer, surgery to remove the tumour or affected tissue is a common treatment, often followed by radiation to eliminate and potential breast cancer cells that may remain.

Breast Cancer Trials has made significant contributions to improved treatments for breast cancer, including:

Personalised treatment plans

Every individual’s treatment plan is tailored to their specific diagnosis, which can vary based on the breast cancer’s molecular makeup, breast cancer stage, and overall health of the individual. Personalising treatment ensures the most effective therapies are chosen to manage the disease.

New treatments for triple-positive breast cancer

Research into new treatment options for triple-positive breast cancer is ongoing, with developments in targeted therapies and immunotherapy. These innovations are aimed at making treatments even more effective while reducing side effects.

A study has identified four distinct subtypes of triple-positive breast cancer, each with unique characteristics and potential treatment options. For some patients, combining multiple HER2-targeting drugs works best, while others may benefit from treatments that block both estrogen and HER2, along with additional targeted therapies.

One subtype could respond well to immune-boosting treatments, while another might require drugs that target specific cell pathways within cancer cells.

By continuing to improve the way in which we classify breast cancers on an individual basis, there is increased hope for more tailored, effective treatments to be delivered, improving outcomes for patients with this type of breast cancer.

Learn more about our recent research results:

  • The PATINA clinical trial – This trial explored the benefit of Palbociclib in combination with HER2 targeting agents Trastuzumab and Pertuzumab as well as endocrine therapy in triple-positive breast cancer.
  • The DIAmOND clinical trial – This trial tests if adding two immunotherapy drugs to Herceptin improves outcomes for people with HER2-positive metastatic breast cancer.

Triple-positive breast cancer prognosis

The prognosis for triple-positive breast cancer can be influenced by a range of factors, including age, tumour stage, and how well the breast cancer responds to treatment. Generally, triple-positive breast cancers tend to have a more favourable prognosis compared to other breast cancer types, due to their sensitivity to targeted treatments.

Factors influencing survival outcomes

  • Age: Younger women may face different challenges than older women due to factors like hormone sensitivity and how the body responds to treatments including side effects.
  • Stage of cancer: Increasing cancer stages indicate more advanced disease. Cancer staging is based on both the nature of the primary tumour and the locations of spread, including to nearby lymph glands. While higher stage cancers are more challenging to treat, advances in therapies have greatly improved outcomes.
  • Response to treatment: Triple-positive breast cancer can respond well to targeted treatments like hormone therapy and HER2-targeted therapy. They may also respond well to non-targeted treatment such as chemotherapy. For example, hormone therapy blocks oestrogen or progesterone, HER2-targeted therapy focuses on the HER2 protein, and chemotherapy works by killing rapidly dividing cells. When the cancer responds effectively to these therapies, the prognosis is usually more favourable.

Advancements in survival rates

Ongoing research is helping improve survival outcomes, with some patients being cured of their cancer thanks to advancements in targeted treatments and personalised care.

According to the Australian Institute of Health and Welfare, the five-year survival rate for stage 1 (early) breast cancer is on average 100%, while stage 2 is 95%. For locally advanced breast cancer (known as stage 3 triple-positive breast cancer), the five-year survival rate is 81% and the five-year survival rate for stage 4 or metastatic breast cancer is 32%.

Patients with triple-positive breast cancer who respond well to treatment, have excellent five-year survival rates.

Triple-positive breast cancer recurrence rate and long-term outlook

The recurrence rate of triple-positive breast cancer depends on factors such as treatment response and breast cancer stage.

Long-term follow-up and monitoring are crucial for detecting early signs of recurrence, ensuring timely intervention.

Triple-positive breast cancer survival rate

With targeted therapies, the prognosis for triple-positive breast cancer is generally favourable, though it depends on many factors. An excellent four-year survival rate is achievable for patients with triple-positive breast cancer who respond well to treatment.

According to a study by Naida Howlader, the highest survival rate was observed in women with the HR+/HER2āˆ’ subtype, with a 92.5% survival rate at four years. This was followed by HR+/HER2+ at 90.3%, and HRāˆ’/HER2+ at 82.7%.

Recurrence rate and long-term outlook

Effective treatment reduces the rate of recurrence for triple-positive breast cancer. For many, the first five years post-treatment are critical for long-term survival and those in remission during this time often have a positive outlook.

Factors influencing recurrence

  • Response to targeted therapy: Patients who receive effective targeted therapies are less likely to experience recurrence.
  • Ongoing monitoring: Long-term follow-up is essential to detect any early signs of recurrence, ensuring timely intervention.

Emerging and new treatments

In the field of breast cancer research, continuous advancements in targeted therapies and immunotherapy have shown great promise for treating many cancers. Notably, combination treatments and new HER2-directed therapies as being developed.

There are also HER2-directed antibody-drug conjugates that aim to deliver a chemotherapy or radioisotope payload towards a HER2 expressing cell, offering more personalised and effective options for patients.

Staying informed

For the latest information on new treatments for triple-positive breast cancer, you can refer to reputable sources such as Cancer Australia. This platform provides updates on research, clinical trials, and new therapies.

Latest advancements

Emerging therapies focus on improving the precision of treatments and medicine, while ensuring the treatment plan is tailored to personalised needs. These advancements include:

Breast Cancer Trials’ Role in advancing research

Breast Cancer Trials plays an important role in leading research and testing innovative trials for breast cancer. Their commitment to advancing clinical trials ensures that patients have access to the latest therapies, providing them with hope and improved outcomes.

Genetic and hereditary factors

Genetic factors can influence a person’s risk of developing triple-positive breast cancer. Testing for mutations like BRCA1 and BRCA2 gene mutations can help assess the risk and provide information on personalised prevention strategies.

The role of genetic testing

Genetic testing can guide treatment decisions and risk assessment, especially for patients with a family history of breast cancer. Genetic counselling can help individuals understand their test results and the implications for their health and family.

Support Breast Cancer Trials

Breast Cancer Trials is a leader in advancing breast cancer research by funding crucial clinical trials aimed at testing new treatments and improving patient outcomes. Through this research, Breast Cancer Trials is helping to shape future treatments for triple-positive breast cancer and other subtypes, providing valuable insights that drive progress in the field.

Breast Cancer Trials also offers opportunities for patients to support or participate in this research. Whether you choose to donate or take part in a trial, your involvement helps move research forward so no more lives are cut short by breast cancer.

References:

  1. Nature: Molecular classification of hormone receptor-positive /HER2-positive breast cancer reveals potential neoadjuvant therapeutic strategies (https://www.nature.com/articles/s41392-025-02181-3)
  2. MD Anderson Center: What is triple-positive breast cancer? 6 insights (https://www.mdanderson.org/cancerwise/what-is-triple-positive-breast-cancer–6-insights.h00-159622590.html)
  3. American Assosicaton for Cancer Research: Differences in Breast Cancer Survival by Molecular Subtypes in the United States (https://aacrjournals.org/cebp/article/27/6/619/71580/Differences-in-Breast-Cancer-Survival-by-Molecular)
  4. Cancer Australia: Diagnosis of early breast cancer (https://www.canceraustralia.gov.au/cancer-types/breast-cancer/how-breast-cancer-diagnosed/diagnosis-early-breast-cancer)

Support research across all types of breast cancer

Latest Articles

clarifying the role of her2-low in early breast cancer

Clarifying the Role of HER2-Low in Early Breast Cancer

early diagnosis and better treatments improve breast cancer outcomes

REVOLUTIONISING RADIOTHERAPY: THE ORNATE STUDY AND THE FUTURE OF BREAST CANCER TREATMENT

Dr Gabrielle Metz is a 2025 clinical fellow with Breast Cancer Trials, and her project is looking to refine radiotherapy for breast cancer patients receiving chemotherapy before surgery.

Dr Gabrielle Metz is a radiation oncologist and 2025 clinical fellow with Breast Cancer Trials. Her project, optimising radiotherapy in the neoadjuvant therapy era, also known as ORNATE, aims to refine radiotherapy for breast cancer patients receiving chemotherapy before surgery.

By creating a multicentre database, researchers can explore whether radiation doses can be safely reduced, and assess less invasive lymph node treatments, all while considering patient experiences and outcomes. We spoke with her about the importance of this research and what it means for patients.

ā€œThere’s been a current trend to increase the utility of neoadjuvant therapy for breast cancer patients. And most of these patients do end up having adjuvant radiotherapy after their surgery. But all of our data to support radiotherapy for breast cancer patients is pre the neoadjuvant era.ā€

ā€œWe don’t actually have good, robust, long-term data that supports or can guide radiotherapy in this particular patient cohort. There has been some recent data that looks at de-escalating treatment or radiotherapy in patients who have an excellent response to neoadjuvant therapy, but the follow-ups are not long enough.ā€

ā€œI wanted to create a registry that captures local women, and local trends in practice where we can possibly have one area where all of their data is collected, and analyse their outcomes, particularly in relation to what radiotherapy they received. We then want to look at reducing the amount of radiation that they’re getting.ā€

Listen to the Podcast

Dr Gabrielle Metz is a 2025 clinical fellow with Breast Cancer Trials, and her project is looking to refine radiotherapy for breast cancer patients receiving chemotherapy before surgery.

Why is it so important to reassess radiation dosing in patients who are responding well to chemotherapy before surgery?

ā€œIn terms of radiotherapy, it’s done really well these days with a deep inspiration, breath hold technique using what we call a Volumetric Modulated Arc Therapy (VMAT) technique, where we can really sculpt our radiotherapy away from underlying structures like the lungs and heart, and target mainly towards the area that we need, so the breast and or the lymph nodes.ā€

ā€œBut treating those areas or those lymph node regions does pose a slight increased risk of toxicity to the lungs and the heart. And if we can de-escalate that and reduce the risk, but still get excellent oncological outcomes for our patients, then that’s our overall aim.ā€

ā€œIn the world of oncology, we are always looking to de-escalate treatments safely for our patients. Patients are living longer, our outcomes are better, and we want to reduce the amount of long-term toxicity that they may receive from any treatment that they get.ā€

How will the multicentre database be structured and what kind of data will it be collecting?

ā€œThe database will be structured on REDCap, and we will be collecting data regarding patient demographics, which will be de-identified, but also based on the patient’s treatment in terms of the type of surgery, the type of neoadjuvant therapy, what they received, and what their pathological response was, as well as in particular the radiation details.”

“So how much radiation they received, and what areas have been targeted by the radiation therapist as well as long-term outcomes in terms of cancer recurrence and survival and toxicity.ā€

What factors are you going to be analysing to determine whether radiation can be reduced for a patient?

ā€œAt the moment, the long-term data, doesn’t support de-escalating or reducing radiotherapy. However, in a certain select group, if it’s agreed upon by the MDT, meaning the patient’s surgeon, medical oncologist, radiation oncologist, and other treating physicians, and the patient has been well-informed, we might be able to look at reducing or omitting radiotherapy to certain areas like the axilla in patients who, who that might be suitable for, who have had a very good response.ā€

How might the findings of this study change current radiotherapy practices for patients?

ā€œI think to change any type of treatment for oncology patients or for any type of patients, we do need to have long-term, robust, randomised evidence, which the registry won’t provide, but it will provide, local data in regard to these women and their delivered treatment and subsequent oncological outcomes that we might be able to extrapolate to a wider audience over time.ā€

ā€œHaving a well-established robust registry for Australian women with breast cancer has endless possibilities in terms of pulling data over time to analyse their outcomes. And that can guide further management in an array of ways, provided it’s done well.ā€

What are your hopes for the future of breast cancer research in this area?

ā€œMy hopes for the future are to continue providing research and striving to allow our patients to be undergoing treatment with as little toxicity as possible, and as little impact to their quality of life as possible, while still maintaining excellent oncological outcomes and survival outcomes for our patients.ā€

ā€œWe have been treating women with breast cancer with radiotherapy for decades. And our outcomes have always been excellent. There are very minimal side effects and toxicity to women, undergoing breast radiotherapy, particularly these days. The dose to the hearts and the lungs are almost negligible.ā€

ā€œAnd it’s a very safe and well tolerated treatment. In saying that, similar to the way that we’re trying to reduce surgery, we’ve gone from mastectomy, removing the whole breast tissue, to a wide local excision, removing only part of the breast tissue. We are looking if we, if we can do that similarly with radiotherapy.ā€

ā€œSo, radiotherapy will remain a really important part of breast cancer treatment because it’s well tolerated and because our outcomes are excellent. But whether we can do that with reducing the areas that we need to treat, then that would only ever be a good thing for patients.ā€

Support Breast Cancer Research

Latest Articles

clarifying the role of her2-low in early breast cancer

Clarifying the Role of HER2-Low in Early Breast Cancer

early diagnosis and better treatments improve breast cancer outcomes

ADCs IN METASTATIC BREAST CANCER: BREAKTHROUGHS, CHALLENGES, AND THE FUTURE OF TARGETED THERAPY

Dr Michelle Li is a 2025 clinical fellow with Breast Cancer Trials, and her project is looking at identifying mechanisms and biomarkers of resistance to ADCs in the treatment of metastatic breast cancer.

Antibody drug conjugates or ADCs are a breakthrough in targeted chemotherapy for metastatic breast cancer. While ADCs like Trastuzumab Deruxtecan, also known as T-DXd, offer new hope for patients, challenges like resistance and various side effects remain and can therefore limit their clinical use.

Dr Michelle Li is a 2025 clinical fellow with Breast Cancer Trials, and her project is looking at identifying mechanisms and biomarkers of resistance to ADCs in the treatment of metastatic breast cancer.

ā€œADCs have rapidly emerged as a highly effective strategy to treat different subtypes of metastatic breast cancer, particularly in comparison to traditional chemotherapy. So, ADCs consist of three components. First, there’s a monoclonal antibody that targets a tumour associated androgen, like a honing missile going towards a particular base.ā€

ā€œThen secondly, there’s a cytotoxic payload or what we traditionally think of as chemotherapy. And finally, there’s the linker, which connects the two. I describe it to my patients as ā€˜Trojan Horse’ chemotherapy.ā€

ā€œSo, the ADCs go right up to the cancer cells, they sneak through the front door, and then they release the chemotherapy once they’re inside to provide maximum targeted damage.ā€

ā€œBecause of its targeted mechanism of action, we can see from the building evidence that ADCs are performing much better than traditional chemotherapy in many settings. And so, we’re trying to bring it earlier into the treatment sequence for our patients with metastatic breast cancer. One ADC that most people might be familiar with or have heard about is Trastuzumab Deruxtecan or T-DXd.ā€

ā€œAnd this is an ADC targeted at the HER2-receptor, and it’s been approved for use in Australia for treatment of not only HER2-positive, but also HER2-low metastatic breast cancer. Based on the pivotal results of the DESTINY-Breast04 and DESTINY-Breast03 clinical trials.ā€

ā€œIn quite exciting news, in September of last year, the results of the DESTINY-Breast06 study came out, which showed that for patients with chemotherapy-naive hormone-receptor-positive of HER2-low, or HER2-ultra low metastatic breast cancer, who had progressed on first line endocrine therapy, T-DXd did better than physician’s choice of chemotherapy, particularly in terms of progression-free survival, and the overall survival data is equally awaited.ā€

ā€œThe presence of HER2 on cells acts like a door for our ā€˜Trojan Horse’ to enter the cancer cell. Traditionally, we’ve thought of cancers as HER2-positive or HER2-negative. However, being HER2-negative doesn’t mean that there’s no HER2-staining of the cell at all. It just means that there’s less of it.ā€

ā€œSo as long as there is staining, so what we refer to as HER2-low or HER2-ultra low, then HER2-negative patients can still benefit from HER2-targeted treatments, as well as of course the HER2-positive patients.ā€

Listen to the Podcast

Dr Michelle Li is a 2025 clinical fellow with Breast Cancer Trials, and her project is looking at identifying mechanisms and biomarkers of resistance to ADCs in the treatment of metastatic breast cancer.

What are the key mechanisms of resistance to ADCs and how do they impact patient outcomes?

ā€œSo, we are very lucky to have access to more than just one ADC for metastatic breast cancer on the Pharmaceutical Benefits Scheme or PBS here in Australia, T-DXd as mentioned earlier, and something else called sacituzumab govitecan or ā€˜SG’ for patients with triple-negative breast cancer who are also HER2-low.ā€

ā€œA question we often face in the clinical setting is, which ADC to give first and which ADC to give second. We know that there are emerging mechanisms of resistance. Real world evidence has shown reduced progression-free survival, so reduced efficacy of both ADCs when given sequentially after one another, which is of course disappointing when patients can’t benefit from the full effect of the second ADC, and research is being done into the key mechanisms of resistance.ā€

ā€œWe don’t know what exactly these are yet, but this is a question we were looking to throughout this research project.ā€

“Work is still ongoing in this field. One theory is that there may be some alterations in the antigen or the ā€˜door’ to cancer cells after exposure to the first ADC, which makes it more difficult for the second ADC to work the same way.ā€

What are the most significant real-world toxicities associated with ADCs and how do they differ from clinical trials data?

ā€œOn paper, the results from the clinical trials comparing ADCs traditional chemotherapy are practice changing. And certainly, in my own practice I have seen excellent results. However, real world toxicities can be significant, and these can often limit our ability to keep giving it to our patients.ā€

ā€œSo sometimes this means we must stop giving it early due to toxicities and switch to the next treatment. Meaning these patients miss out from getting maximal benefit from these drugs.ā€

ā€œOnes that I see most commonly in my practice, would be nausea, vomiting, and cachexia or weight loss. It’s interesting because some patients will do just fine and some will do quite terribly with these side effects and require the use of lots of different types of anti-nausea medications.ā€

ā€œAnd sometimes that’s not even enough. And so, one thing that we are doing in this clinical fellowship is looking for potential biomarkers such as something called Growth Differentiation Factor-15 or ā€˜GDF-15’, which might predict those patients that will have these symptoms and see whether we could intervene a bit earlier.ā€

ā€œOne of the other significant real-world toxicities of T-DXd is ILD, so interstitial lung disease, also known as pneumonitis. And this is inflammation of the lungs. This can result in a cough, shortness of breath, and in rare or more serious scenarios, it can cause respiratory distress or death. We saw a small but significant number of patients who experienced this in the early DESTINY-Breast studies. However, as time has gone by, we’ve become more familiar with the drug and we’re getting a lot better at monitoring for this and also managing this.ā€

ā€œSo, outcomes are improving, but of course, this is still something to look out for. So, in the next decade, I’m actually very excited to see where ADCs will go. I think we will see ADCs being brought into the first line setting, particularly for HER2-positive, metastatic breast cancer. And right now, a lot of focus is in the metastatic setting, but I think we’ll see it also being brought into the adjuvant setting.ā€

ā€œAfter patients have had curative surgery for their early breast cancer, and in combination with other treatment management strategies such as endocrine therapy for hormone-receptor-positive breast cancer patients; I also think we will see other exciting combinations come through.ā€

ā€œFor example, there are currently trials underway combining ADCs with immunotherapy, particularly in the triple-negative metastatic breast cancer setting, and possibly a combination with other targeted agents as well, such as PARP inhibitors.ā€

ā€œThere are many emerging ADCs in development with other novel targets. So, I’ve talked about HER2 with T-DXd, but there are also other targets that are coming through such as HER3, or Nectin-4B. And some of this is based on inspiration that we’re getting from our other oncology colleagues from other tumor streams.ā€

ā€œIt’s going be invaluable to work with some of the most innovative minds in the field. The next steps in my research project are, of course, number one, getting over there. But number two, setting up some international research protocols. And number three, collecting and examining data from some large pre-existing breast cancer registries at Dana-Farber.ā€

What are the next steps in your research and how might international collaboration contribute to advancing this field?

ā€œOncology is a global specialty, and international collaboration is vital to making advances in treating breast cancer. Dana-Farber is one of the world’s leading cancer research institutes and is forging the way with research into not only targeted treatments such as ADCs, but also has led practice-changing research into supportive management and improving quality of life.ā€

What are your hopes for the future of breast cancer research in this space?

ā€œI hope that many of the drugs that we give will be as effective as possible in not only holding the disease where it is, but even improving the disease burden. I think that cure is something obviously that we’re trying to aim for at all times, and you know, that’s the ultimate goal that breast cancer is going to be curable for patients.ā€

ā€œI think that managing quality of life is going to be important and managing any of the symptoms that come from our treatment, because if the treatment is effective, that’s great, but you’re going to have to be able to have a decent quality of life while you’re undergoing treatment for this, so that you can spend meaningful time with your loved ones.ā€

Support Breast Cancer Research

Latest Articles

clarifying the role of her2-low in early breast cancer

Clarifying the Role of HER2-Low in Early Breast Cancer

early diagnosis and better treatments improve breast cancer outcomes

BEYOND THE CLINIC: HOW ePRO IS REVOLUTIONISING METASTATIC BREAST CANCER CARE

Dr Victoria Rayson is a 2025 clinical fellow with Breast Cancer Trials, and we spoke with her about the feasibility benefits and real-world impact of ePRO in the Australian healthcare setting.

Electronic Patient Reported Outcome or ePRO remote monitoring is a game changer for people living with metastatic breast cancer. Many patients on treatments like CDK4/6 inhibitors and anti-HER two therapies remain stable for long periods. Yet, they still have to attend frequent checkups. But what if we could safely monitor their health from home?

ePRO remote monitoring is a validated and practical solution that reduces unnecessary hospital visits, improves patient outcomes, and eases pressure on the healthcare system. Dr Victoria Rayson is a 2025 clinical fellow with Breast Cancer Trials, and we spoke with her about the feasibility benefits and real-world impact of ePRO in the Australian healthcare setting.

ā€œSo, I have been very fortunate to be awarded a clinical fellowship with Breast Cancer Trials (BCT). And the project that I’ll be looking at is implementing electronic patient reported outcomes. So electronic digital monitoring in a breast cancer population in a big tertiary hospital. And looking to see whether it improves patient outcomes and also whether there’s any economic benefits from implementing such a service.ā€

ā€œWe are looking to implement a remote digital monitoring for patients with metastatic breast cancer in particular. The number of patients who are living with metastatic breast cancer is growing. We have more patients on treatment for longer periods of time and we want to support them to be able to live well, while on treatment.ā€

ā€œAnd part of living well on treatment is trying to reduce the healthcare contact points, so they can continue doing what they want to do. Looking after children, working, traveling. And I do feel that digital remote monitoring, and using patient reported outcomes is a way to do that.ā€

Listen to the Podcast

We spoke with Dr Victoria Rayson about the feasibility benefits and real-world impact of ePRO in the Australian healthcare setting.

How do you think ePRO remote monitoring could improve patient care compare to traditional in-person reviews?

ā€œYeah, so look, I mean, breast cancer is a varied disease, so patients are on all sorts of different treatments. For metastatic breast cancer we have some patients who are on oral therapies that are generally very well tolerated but they do sort of still have symptoms and other important issues that do pop up.ā€

ā€œWe also have patients who are on chemotherapies and also some targeted therapies like anti-HER2 therapies. So, patients can be on treatments for a very long period of time and remain quite stable. So, this project in particular is looking at whether we can improve the care of these patients who are on stable treatments.ā€

ā€œSo firstly, by earlier detection of symptoms and addressing these symptoms in a proactive manner rather than a reactive manner. Secondly, in terms of whether we can reduce the healthcare contact points, so perhaps having less frequent clinical reviews. We know that patients who have cancer, there’s an enormous time toxicity in cancer treatment and its sort of focusing on trying to reduce that.ā€

ā€œWe’ve got more patients living on treatment at the moment, and unfortunately, the number of patients who are on treatment is outpacing our workforce growth. We need to work smarter rather than harder on caring for our patients in order to live and continue delivering high-quality care to them.ā€

ā€œWe are very hopeful that we’ll be able to manage patients in the community rather than bringing them into hospital for assessments, you know, for admissions or emergency presentations. So, continuing to allow patients to be at home and doing what they want to do for more time.ā€

ā€œIn terms of barriers to this project, we love seeing our patients who are doing well. And so, one barrier to reducing those contact points is clinician satisfaction. And also, there is a potential impact on the relationship that we do develop with our patients if we’re seeing them less.ā€

ā€œSo, we really need to be careful about developing a system that appreciates that and maintains that human connection and contact, throughout their care.ā€

ā€œClinicians addressing the problems that patients raise as being important to them, that’s really key in all of this that we are addressing. So that includes what is important to patients and helping to facilitate communication between patients and clinicians.ā€

How do you think remote monitoring could impact a patient’s quality of life and their sense of engagement in their own care?

ā€œPatients love to track. Everyone seems to love to track their symptoms, what they’re eating, and what they’re exercising on a daily basis these days. And I’ve certainly seen that in patients in the clinic. I think that designing a system whereby patients and clinicians are tracking similar things, and we are actually looking at the same values, and the same metrics to improve or to enhance sort of patient-centred care, is a great outcome.ā€

How do you foresee the cost effectiveness of ePRO being evaluated?

ā€œWell, I mean, the cost effectiveness is a challenging thing to measure actually. It’s quite complex. On a basic level, we are looking at whether we can reduce those health service contact points, so nurse service utilisation, clinic visits, hospital presentations and admissions. But, in the future we will look to do a more thorough economic analysis in terms of quality-of-life adjusted years etc.ā€

ā€œBut you know that’s further down the road. You know, the first part of this project is certainly more about implementation of the electronic patient reported outcomes in the clinic.ā€

In what ways could ePRO remote monitoring reduce the burden on healthcare resrouces and improve system efficiency?

ā€œI think the exciting thing about implementing patient reported outcomes in the clinic is making sure that we’re addressing the things that are important to patients. So, you know, often a patient might feel like, their doctor was running an hour late. They don’t want to bring up that thing that’s going to take 45-minutes to discuss.ā€

ā€œOr perhaps they’re embarrassed to talk about some of the issues that do affect our patients with breast cancer. So, sexual dysfunction, emotional or psychological needs. And I think that patient reported outcomes really provides clinicians a way of ensuring that we’re addressing those needs that are really important to patients.ā€

ā€œAnd hopefully we may actually see that we can do that in a more efficient manner as well. It’s a strategic importance to many organisations involved in cancer care, both in Australia and internationally as well. Patient reported outcomes have been incorporated into many guidelines internationally.ā€

ā€œAnd certainly, our local organised cancer organisations are very keen to incorporate patient reported outcomes into routine clinical care. That implementation into routine practice has been varied across Australia and there’s a lot of work to be done on, on making sure that we are doing that.ā€

ā€œWe’ve got good data now across a number of tumour streams for monitoring symptoms and also monitoring health related quality of life.ā€

ā€œI think this is an exciting project to be involved in. I really do think that it has the potential to create a huge difference on a personal level for patients, whether it be spending less time in hospital, in clinic, on the phone to doctors and more time enjoying their lives, or whether it’s about earlier monitoring of symptoms with improved management of them. I think on a patient level, this project has a huge potential to create positive effects for patients.ā€

What are the current challenges faced in monitoring patients with metastatic breast cancer on systemic therapies?

ā€œThere’s a huge time toxicity involved in cancer care and in particular for women who have metastatic breast cancer who are on treatment for very long periods of time. And are often coming in and out of hospital for appointments has a huge impact on their life, and their ability to get on with doing what they want to do, especially for patients who live further away.ā€

ā€œSo, whether that be, outer metropolitan cities. Or even regionally as well using electronic or digital remote monitoring is really important. It’s an important strategy to try and improve the care of these patients and reduce the amount of time they spend attending their cancer clinics and care.ā€

Support Breast Cancer Research

Latest Articles

clarifying the role of her2-low in early breast cancer

Clarifying the Role of HER2-Low in Early Breast Cancer

early diagnosis and better treatments improve breast cancer outcomes
split-banner-image

Alcohol and Breast Cancer – Understanding the Risks

Breast cancer and alcohol have long been linked and understanding how alcohol affects breast cancer risk is essential for individuals seeking to make informed lifestyle choices.

Cancer Australia states that alcohol increases the risk of breast cancer in all women and women who drink one standard glass of alcohol per day, have a 7% higher risk of breast cancer, compared to women who never drink alcohol.

The World Health Organization (WHO) advises that there is no safe level of alcohol consumption and the risk of breast cancer increases with each unit of alcohol consumed per day.

Breast Cancer Trials (BCT) conducted a Q&A event on the role and impact of diet and exercise in breast cancer, which included aĀ discussion on the risk factors caused by alcohol.

Does alcohol cause breast cancer?

Alcohol consumption contributes to the development of breast cancer. Cancer Australia estimates that nearly 6% of breast cancer cases each year in Australia are due to alcohol consumption.

Cancer Research UK highlights three main reasons why there is a link between alcohol and breast cancer:

  • When we drink alcohol, it’s broken down into a toxic chemical called acetaldehyde. Acetaldehyde can damage the DNA inside our cells and then prevent this damage from being repaired. This is important because it allows cancer to develop.
  • Alcohol can increase the levels of certain hormones in the body, including oestrogen. We know that high levels of oestrogen can fuel the development of breast cancer, which is an important factor to keep in mind.
  • Alcohol also makes it easier for cells in the mouth and throat to absorb other cancer-causing chemicals. This is probably more important for other cancer types linked to alcohol rather than breast cancer.

There have been many studies that have confirmed the link between alcohol and breast cancer, which are contained in a Cancer Australia report titled ā€˜Risk factors for breast cancer: A review of the evidence 2018.’ It includes evidence from:

  • The International Agency for Research on Cancer (2012), who concluded that there is ā€˜sufficient evidence’ that ā€˜alcohol consumption causes cancer of the breast.’
  • Alcohol and breast cancer risk new findings include a 2018 research project by the World Cancer Research Fund International and the American Institute for Cancer Research shed important light on this connection. The study, which analysed evidence from 62 separate studies, highlights the growing body of research linking alcohol consumption to an increased risk of breast cancer.

Breast Cancer Trials encourages individuals to assess their breast cancer risk using tools like iPrevent.

How much does alcohol increase breast cancer risk?

The connection between alcohol and breast cancer risk is dose-dependent, meaning the more alcohol consumed, the higher the risk of developing breast cancer. Studies indicate that for every additional 10 grams of alcohol (roughly one standard drink) consumed per day, the risk of breast cancer increases by 7% (National Cancer Institute).

Even light drinking, up to one standard drink a day, has been linked to an increased risk of developing breast cancer. It is suggested that there is no safe threshold for alcohol consumption regarding breast cancer risk. It’s essential for individuals to understand that alcohol and breast cancer are strongly connected, and reducing alcohol consumption can help lower this risk.

Research by Turning Point Australia suggests that 1 in 15 breast cancer cases and 1 in 5 breast cancer deaths in Australia are linked to alcohol consumption. For more information on ways to reduce breast cancer risk, including through lifestyle changes, visit our article onĀ  breast cancer prevention.

Which type of breast cancer is linked to alcohol?

Cancer Australia states that alcohol may increase breast cancer risk in a number of ways, including helping cancer-causing molecules to enter cells or damaging cell DNA.

The connection between alcohol and breast cancer is strongest with hormone receptor-positive cancers, such as oestrogen receptor-positive (ER+) cancers. These cancers are influenced by oestrogen, and alcohol can raise oestrogen levels in the body, which may assist these cancers to grow. However, alcohol has also been linked to oestrogen receptor-negative (ERāˆ’) breast cancers. This means that even if a cancer isn’t fuelled by oestrogen, alcohol can still increase the breast cancer risk (PubMed Central).

Alcohol and breast cancer risk after menopause

Alcohol consumption can increase the risk of breast cancer for all women.

Alcohol intake is linked to an increased risk of hormone receptor-positive breast cancers, which are more common after menopause. What makes this even more complex is the interaction between oestrogen based hormone replacement therapy (HRT) and alcohol. Some women use HRT to manage menopausal symptoms. Since alcohol can also raise oestrogen, the combination can further increase the risk of developing oestrogen-sensitive breast cancers.

It’s important to understand how these factors can work together when considering your health choices.

For more information on hormone replacement therapy and its potential impact on breast cancer, you can check out the resources provided by Breast Cancer Trials here.

Alcohol and breast cancer recurrence

For women who have had breast cancer, alcohol consumption can affect the risk of cancer returning. Drinking alcohol raises oestrogen levels, which can fuel the growth of oestrogen-sensitive breast cancers. This can increase the chances of recurrence, particularly for women in remission or those with hormone-receptor positive cancers.

It’s important for those in remission to understand how alcohol and breast cancer recurrence are connected. By limiting alcohol intake, individuals can reduce the risk of cancer returning and help maintain the effectiveness of treatments like oestrogen blocking medications.

What patients need to know about drinking alcohol with cancer

If you’re undergoing breast cancer treatment, it’s important to understand how alcohol might affect your treatment and overall health. Alcohol can interact with many cancer medications, in some cases decreasing their effectiveness or increasing side effects such as fatigue, nausea, and liver toxicity. In addition, drinking alcohol while undergoing treatment can weaken your immune system, leaving you more vulnerable to infections – something that’s especially concerning when your body is already under stress from cancer treatment.

If you’re receiving treatment for breast cancer, it’s essential to have a conversation with your oncologist about alcohol consumption. They can help you understand the potential interactions and guide you on how to manage alcohol intake safely during treatment.

The role of Breast Cancer Trials in advancing research

Breast Cancer Trials is at the forefront of advancing treatments for breast cancer, through clinical trials research.Ā  For more than 45 years, we have conducted a national and international clinical trials research program into the treatment, prevention and cure of breast cancer.

All treatments currently used in the clinic in Australia and New Zealand, have undergone a clinical trial to ensure efficiency and safety of patients. Some examples of cancer care milestones that have been achieved through clinical trials research are:

  • Chemotherapy and hormone treatment which are effective for preventing breast cancer recurrence and can save lives.
  • Mammograms which save lives through early detection of disease.
  • Surgical procedures such as lumpectomies which enable surgeons to safely remove the cancer whilst preserving the breast.
  • Drug treatments such as Tamoxifen which can prevent breast cancer in women with an increased risk of developing the disease.
  • Personalised and targeted treatments which enables a specific cancer type to be targeted with a treatment that can improve patient outcomes substantially.

FAQs

Is there cancer risk from alcohol consumption?

Yes, there is a strong link between alcohol and breast cancer and each additional drink increases your likelihood of developing breast cancer. Even light drinking can increase risk.

Research from the Cancer Council Australia indicates that alcohol is a known carcinogen and contributes to the development of various cancers, including breast cancer.

Does quitting drinking reduce breast cancer risk?

Yes, quitting drinking can reduce the risk of breast cancer. Alcohol consumption is causally linked to several cancers, including breast cancer.

No amount of alcohol is entirely risk-free when it comes to cancer, and reducing alcohol intake can help lower this risk. ā€œEven drinking small amounts of alcohol increases the risk of cancer, and the more you drink, the greater the riskā€ (Cancer Council).

It’s advisable for individuals undergoing treatments to consult with their healthcare providers regarding alcohol consumption. Healthcare providers can offer personalised guidance based on the latest research and the individual’s specific health context.

Sources:

  1. Alcohol and Drug Foundation: Alcohol and breast cancer (https://adf.org.au/insights/alcohol-breast-cancer/)
  2. Cancer Research UK: Alcohol and breast cancer – how big is the risk? (https://news.cancerresearchuk.org/2017/05/25/alcohol-and-breast-cancer-how-big-is-the-risk/)
  3. Cancer Australia report titled ā€œRisk factors for breast cancer: A review of the evidence 2018ā€ (https://www.canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/risk-factors-breast-cancer-review-evidence-2018)
  4. Cancer Council Australia: Alcohol use, awareness and support for policy measures (https://www.cancercouncil.com.au/wp-content/uploads/2023/06/Community-Survey-on-Cancer-Prevention-Alcohol-Short-Report-2022.pdf)
  5. Cancer Council: Alcohol and Cancer (https://www.cancercouncil.com.au/cancer-prevention/alcohol/alcohol-and-cancer)
  6. PubMed Central: Alcohol consumption and breast cancer risk by estrogen receptor status: in a pooled analysis of 20 studies (https://pmc.ncbi.nlm.nih.gov/articles/PMC5005939/)
  7. Turning Point Australia: Do the women you care about know that alcohol can cause breast cancer? (https://www.turningpoint.org.au/about-us/news/reduce-breast-cancer-cases)
  8. National Cancer Institute: Alcohol and Cancer Risk (https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet)

About Breast Cancer Trials

Breast Cancer Trials is a world-leading research organisation dedicated to advancing breast cancer treatments through groundbreaking clinical trials, ensuring the most accurate and up-to-date information on skin changes and other breast cancer symptoms.

Sign up to our newsletter to stay up to date with the latest breakthroughs

Name(Required)

Clinical trials research saves lives

Latest Articles

clarifying the role of her2-low in early breast cancer

Clarifying the Role of HER2-Low in Early Breast Cancer

early diagnosis and better treatments improve breast cancer outcomes
split-banner-image

BREAST CANCER SKIN CHANGES

Skin changes are a breast cancer symptom that can be an early warning sign. Learn what to look for, what causes skin changes, and when to seek help from an expert.

Skin Changes: A Breast Cancer Symptom

Breast cancer can cause visible skin changes due to the underlying tumour affecting the skin, blood vessels and the lymphatic system. It’s important to recognise unusual skin changes and discuss any concerns you may have with your GP.

Common types of breast cancer skin changes

Skin changes that may indicate breast cancer can include:Ā 

  • redness,Ā 
  • dimpling,Ā 
  • thickening of the skin on the breast or underarm,Ā 
  • ulceration,Ā 
  • scaliness,Ā 
  • persistent itching,Ā 
  • nipple retraction, darkening or discoloration, and theĀ 
  • development ofinflammation, open sores or non-healing wounds.

Changes to skin texture in breast cancer

Some of the following skin changes on breast cancer can occur:

  • Skin ulceration and open sores: Advanced breast cancer can invade the skin, causing ulcers or open wounds that may not heal. This is commonly known as a ā€˜Fungating Breast Tumour’. This type of tumour emerges when the cancerous mass breaks through the skin, resulting in the formation of a wound and can lead to bleeding, oozing, or infection.
  • Nipple and areola changes: Cancer can cause the nipple to flatten, retract, or become inverted. Skin around the nipple may become scaly, flaky, or develop a rash, which could indicate Paget’s disease of the breast, a rare type of breast cancer.
  • Skin discoloration: The breast skin may turn red, purplish, or darker due to cancer-related inflammation or blood vessel damage.
  • Firm, raised lumps under the skin: Cancer can form hard, immobile lumps under the skin, sometimes causing an uneven or bumpy surface. Some describe this bumpy surface like orange peel skin on the breast.
  • Itching or burning: Some breast cancers, especially inflammatory breast cancer, can cause persistent itching or irritation similar to an infection, but does not improve with antibiotics.

Examples of breast cancer skin changes

It’s important to see your doctor if you notice any of the below skin changes or breast cancer symptoms:

  • discharge from the nipple,Ā 
  • growth of the veins,
  • pulling on puckering of the skin under the tumor,
  • redness, hot skin, swelling,
  • a recess,
  • resizing of the breast or obvious asymmetry,
  • thinning of the breast skin,
  • retraction of the skin on the chest,
  • destruction of the skin.

breast cancer skin changes pictures. it's important to see your doctor if you notice any changes to the skin on or around your breast.

Additional breast cancer symptoms accompanying skin changes

In addition to skin changes, breast cancer symptoms can include:

  • breast pain,Ā 
  • nipple discharge,Ā 
  • a deep or hard lump,Ā 
  • changes in breast size or shape,Ā 
  • a feeling of heaviness or tightness,Ā 
  • fatigue,Ā 
  • unexplained weight loss, andĀ 
  • bone pain.

Holistic symptom awareness for breast cancer involves understanding the physical, emotional and lifestyle-related changes that might indicate underlying issues. This includes:

  • Body Awareness: Understanding what is ā€˜normal’ for you in terms of breast shape, size, and how it might fluctuate over time. Also noticing any tenderness, changes in colour or irregular lumps.
  • Mind-Body Connection: Noticing persistent fatigue, stress, or emotional shifts that may signal underlying health concerns.
  • Pain and Sensation Tracking: Paying attention to subtle, persistent discomfort, deep aches, or unexplained heaviness in the breast or body.
  • Energy and Well-Being Monitoring: Recognising unexplained weight loss, decreased energy levels, or prolonged feelings of imbalance.
  • Lymphatic and Circulatory Awareness: Being mindful of swelling in the armpits, neck, or breasts, which could indicate lymph node involvement.
  • Intuitive Health Checks: Trusting gut instincts when something feels “off” and seeking medical attention even in the absence of obvious symptoms.

Monitoring and understanding breast cancer skin changes

Skin changes, such as redness, dimpling, thickening, or ulceration, can be early warning signs of breast cancer. These symptoms may indicate underlying tumour growth or lymphatic blockage, requiring prompt medical attention.

Breast cancer symptoms may also include lumps, nipple discharge, persistent pain, unexplained weight loss, and fatigue. Being aware of subtle changes in the body and discussing these with your GP is essential for early detection.Regular clinical check-ups and mammograms increase the chances of detecting breast cancer early, when it’s most treatable.

Understand your personal breast cancer risk

Using risk assessment tools, like our free iPrevent online tool, can help you understand your personal risk and take preventive action.

About Breast Cancer Trials

Breast Cancer Trials is a world-leading research organisation dedicated to advancing breast cancer treatments through groundbreaking clinical trials, ensuring the most accurate and up-to-date information on skin changes and other breast cancer symptoms.Ā 

Sign up to our newsletter to stay up to date with the latest breakthroughs.

Name(Required)

Support Us

Help us to change lives through breast cancer clinical trials research

Latest Articles

clarifying the role of her2-low in early breast cancer

Clarifying the Role of HER2-Low in Early Breast Cancer

early diagnosis and better treatments improve breast cancer outcomes