BREAST CANCER

Breast cancer is the most common cancer occurring amongst Australian women and accounts for approximately one third of all female cancer diagnoses.

Each year approximately 18,000 women are diagnosed with breast cancer in Australia.

The incidence of breast cancer occurrence has increased steadily over the past 40 years, and in 2018 it is estimated that the risk of a woman being diagnosed with breast cancer by their 85th birthday will be 1 in 8 (12.5%).

However the good news is that more and more women are beating the disease with the average rate of survival increasing to 91% in the years 2010-2014.

The explanation for the recent fall in the mortality from breast cancer is considered to be due to the important benefits of mammographic breast screening which has enabled earlier detection, combined with the more liberal and effective use of systemic drug therapies.

In the modern era, the majority of women diagnosed with breast cancer can be managed with breast conservation therapy, thus avoiding the need for mastectomy.  The current breast conserving protocol includes the following components:

  1. Complete excision of the primary tumour from the breast.
  2. Sentinel node biopsy of the axillary lymph nodes.
  3. A course of radiotherapy treatment to the affected breast.

Sentinel node biopsy is a technique for managing the axillary lymph nodes which involves the detection and removal of the main drainage node in the axilla from the affected area of the breast, to determine if metastatic spread has occurred, and hence whether an axillary clearance is required.  The technique of sentinel node biopsy involves the peri-tumour injection of both a radio-isotope and blue dye into the breast, after which the axilla is explored to locate a hot blue node or nodal cluster signifying that this is the sentinel node.  The sentinel node is thus excised and sent for histological evaluation.  If no cancer cells are found within the node no further action is required, however if cancer is found within the node then a formal axillary clearance is usually indicated.

For women who require a mastectomy as part of their treatment, and providing the circumstances are appropriate, consideration can be given the performance of an immediate reconstruction.  In this scenario Professor Bennett has long-term affiliations with several Plastic Surgeons to enable the undertaking of combined simultaneous surgical interventions to facilitate such an outcome.

The more widespread use of adjuvant drug therapies has played a significant role in the recently observed improvement in survival of breast cancer patients.  For this reason the majority of breast cancer patients will receive some form of systemic or drug therapy in addition to local surgery and radiotherapy treatments, but such treatments are tailored for each patient depending upon the characteristics of the cancer and the stage of tumour development.  These therapies may include hormonal therapy, chemotherapy or Herceptin.

Professor Ian Bennett has over 25 years of experience in the management of breast cancer patients and is also aware of the importance of a multidisciplinary approach to the management of breast cancer and has a number of affiliations with medical oncology groups and radiotherapy services to work for the best possible outcomes for patients diagnosed with this condition.

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