Breast cancer is the most common cancer affecting Australian women. In a 2019 report, the Australian Institute of Health and Welfare estimated that 19,998 women and 170 men will be diagnosed with breast cancer in 2020, an average of 55 people per day.
The number of women and men being diagnosed with breast cancer in Australia is increasing, but thankfully the number of deaths from breast cancer is decreasing.
Australia has one of the best breast cancer survival rates in the world. The chance of surviving at least 10 years after treatment is 85 percent. Increasing survival is due to earlier diagnosis through screening and improved treatments.
Early diagnosis and improved survival rates can also be attributed to ongoing support for breast cancer awareness. The colour pink is synonymous with breast cancer support, with everything from supermarket products to iconic Australian landmarks taking on a pink guise in support of breast cancer research.
Celebrities such as Kylie Minogue, Christina Applegate, Cynthia Nixon, Olivia Newton-John and Sheryl Crow who have suffered publicly from breast cancer use their fame to become ambassadors for the cause, putting their name to government initiatives and helping raise fundraising efforts even further.
What Is Breast Cancer?
‘Breast cancer, like other cancers, occurs because of an interaction between the environment and a defective gene,’ explains German anti-ageing specialist Dr Michael Klentze. ‘Specifically, breast cancer occurs when a build up of genetic mutations in critical genes – those that control cell growth and division, or the repair of damaged DNA – allow cells to grow and divide uncontrollably to form a tumour.’ ‘Breast cancer, like prostate cancer, is a hormone-dependent cancer, which can develop under oestrogen influence,’ he explains.
Although it is much more common in women, men can also develop breast cancer.
There is a medical distinction made between early breast cancer and secondary breast cancer. Early breast cancer is cancer that is contained within the breast and may or may not have spread to the lymph nodes (located under the armpit). Secondary breast cancer is cancer that has spread outside the breast area. This distinction helps dictate the best treatment option.
Treatment
‘Breast cancer is commonly treated by various combinations of surgery, radiation therapy, chemotherapy and hormone therapy,’ says Dr Klentze. There are a number of factors that influence the selection of breast cancer treatment. According to Dr Klentze, these include the age and menopausal status of the patient, the stage of the disease and whether the tumour is aggressive or likely to spread.
Another influential factor is whether the tumour contains oestrogen receptors (ER+) or progesterone receptors (PR+). These receptors indicate if hormones are causing the cancer to grow bigger; there are specific hormone-blocking medications for each that can be used during treatment.
Women with breast cancer usually undergo a lumpectomy (the surgical removal of a cancerous nodule) or a mastectomy (removal of the entire breast/s) to excise the cancer from the breast, which can be followed by radiation therapy and/or chemotherapy to kill any remaining cancer cells.
The Angelina Jolie Effect
Discoveries in genetic research has provided some valuable information that can help identify whether a person is more susceptible to breast cancer in the first place, therefore increasing the chance of early detection.
BRCA1 and BRCA2 are major genes related to hereditary breast cancer. Women, and also men, who have inherited certain mutations in these genes have a higher risk of developing breast cancer, ovarian cancer and several other types of cancer during their lifetimes.
This breakthrough means that people can now be tested for these particular genes – and those who carry them can be aware of their susceptibility and closely monitor their breasts for any suspicious changes.
Perhaps the most famous carrier of the BRCA1 or BRCA2 gene mutation is actress Angelina Jolie.
The news that Jolie – one of the world’s most glamorous women – had undergone a double mastectomy at the age of 37 stunned the world in 2013 and brought this very relevant public health issue to the forefront of international media.
Faced with an 87 percent chance of developing breast cancer in the future, Jolie underwent her procedure as a preventative measure – one that brought her risk of developing the disease down to just five percent. It’s thought around five percent of Australians – both men and women – carry the BRCA1 and BRCA2 gene. The availability of genetic testing varies across the country. Contact the Cancer Council Australia for more information. CBM
Check Yourself
To ensure the best possible outcome, early detection is all-important. As with all types of cancer, the risk of breast cancer spreading from the breasts to other parts of the body increases dramatically if it is not detected early. The good news is that the knowledge, technology and medical expertise is all readily available here in Australia to help women take charge of their breast health.
It is critical every woman knows how to do breast self-examination. As of age 20, self-checking using the points below should be a monthly routine:
- Most doctors recommend lying down with one arm behind your head. With the other hand, feel each breast with your middle three fingers for any irregular lumps, cyst-like formations, thickening or unusual dimpling. Be sure to feel the entire breast area – from the top of the chest, under each arm, around the breast mound and down towards the rib cage.
- You can also look at your breasts in the mirror, both with your hands on your hips and in the air. Check for changes in colour, shape, nipple location, dimpling or anything that is irregular.
- Use your thumb and forefinger to gently press the nipple and check for any irregular discharge.
- It is not a cause for panic if you do come across an anomaly – 80 percent of lumps turn out to be benign – but you should consult with your doctor as soon as possible to be sure.
- For pre-menopausal women especially, aim to perform the self-exam at the same time each month, ideally after your period. As your breasts change as you go through your menstrual cycle, by examining them at the same point in your cycle, you can make a more accurate comparison.
Some changes to look for:
- A new lump, or lumpiness, especially if it is in one breast.
- Nipple discharge.
- Change in the size or shape of the breast or nipple.
- Change in the skin over the breast, such as redness or dimpling.
- Unusual persistent pain, especially if it is one breast.
- If you’re concerned by a family history of breast cancer, or by any changes to your breasts, speak to your doctor as soon as possible.
Reducing Your Risk
While there is no known way of preventing breast cancer, making lifestyle changes such as quitting smoking, reducing alcohol intake, reducing fat mass and increasing exercise can all help to reduce the risk of breast cancer. You may also wish to consider getting tested to find out if you are susceptible to breast cancer, especially if there is a family history of the disease. Having a firstdegree relative, such as your mother or sister, with breast cancer puts you at higher risk for the disease. The risk is even greater if they developed breast cancer before menopause, and in both breasts.
Thousands at risk of undiagnosed cancer during COVID-19
Since the start of the COVID-19 pandemic, there has been a 30 percent fall in referrals to cancer specialists, according to media reports. That’s because fewer people are seeing their GPs and avoiding routine pathology tests.
Pink Hope CEO and Founder Krystal Barter said delayed diagnoses and treatment could be devastating for women at high-risk for, or in the early stages of, breast and ovarian cancer. ‘If you are in a high-risk group, then it’s absolutely critical you seek information and support for options available to you during the coronavirus pandemic,’ she said. Specialist Oncoplastic Breast Cancer Surgeon Dr Jane O’Brien said there has been roughly a 40 percent decline in breast cancer diagnoses over the last few months. ‘It is important for people to keep up with their cancer screening, especially for those at high risk, even if face-to-face clinical consultations with their specialists may have been suspended during the pandemic,’ she said.
‘Approximately 60 percent of breast cancers occur in the screening age of 50 to 74 years, and this typically accounts for almost half of all breast cancer diagnoses. However, since COVID-19 there will have been 30 percent fewer cancers diagnosed in that age group due to suspended screening.’
