A new study shows that Australian women may be missing out on lifesaving breast cancer treatment because they don't know if their cancer is sensitive to hormone therapy.
Findings of the Bupa Health Foundation's 'Health and Wellbeing after Breast Cancer Study', conducted by Monash University, showed that 38 percent of women who were hormone receptor positive-that is, they had hormone-sensitive cancers-were not aware of their hormone receptor status. This information can affect what treatment will be offered to women diagnosed with breast cancer.
This study aimed to look at what and how much women with newly-diagnosed invasive breast cancer knew and understood about breast cancer that had an impact on their treatment. The 1,684 women enrolled in this study were all diagnosed with invasive breast cancer between 2004 and 2006 in Victoria and were aged between 26 and 88 at diagnosis.
As part of the study, they completed a questionnaire within 12 months of their diagnosis that asked about their oestrogen receptor (ER) and progesterone receptor (PR) status and about their past or current treatment with endocrine therapy.
Endocrine therapy includes the removal of the ovaries or the use of drugs such as tamoxifen. Endocrine therapy reduces the likelihood of cancer recurrence by about one third for women with hormone-sensitive breast cancers, significantly improving their survival chances.
Dr Christine Bennett, Chair of the Bupa Health Foundation Steering Committee and inaugural member of the NSW Program for Mammographic Screening Committee, says it's essential that women are helped to know their hormone receptor status and understand how that information can impact their condition and available treatment.
"Doctors need to make sure patients are told and understand the hormone receptor status, and how that affects the treatments appropriate for them," she said.
Professor Susan Davis of the Women's Health Program at Monash University who led the study said that the findings were important and show that despite best efforts, critical issues are still not being communicated to patients.
"Women with breast cancer need to understand the implications of the decisions they make with their doctors about their treatment," Professor Davis said. She added that the results of the survey were surprising given that it was conducted at the same time as a breast cancer awareness campaign.
The study also found that women who are older or less educated were less likely to know their hormone receptor status. Women who were unable to complete the survey in English were excluded from the study, which means the extent of the problem could even be underestimated.
Dr Bennett said that women with breast cancer shouldn't be afraid to speak up about their treatment even though breast cancer is so personal for some women.
"If women don't understand what they are being told they can obtain more information either through the excellent resources available via the National Breast and Ovarian Cancer Centre or Breast Cancer Network of Australia or ask more questions," Dr Bennett said. "Communication isn't expensive, and it can save lives."
According to the Cancer Council, each year around 2,600 Australian women die from breast cancer, and more than 12,000 are diagnosed with it. While mortality rates are improving, the Monash findings underscore the importance of ongoing research into prevention. They also suggest that more work needs to be done to help women understand more about the nature of their breast cancer.
Key facts about breast cancer
- Breast cancer is the second most common invasive cancer in women after non-melanoma skin cancer. It is uncommon in males, with a 1 in 730 risk of being diagnosed by age 85, in contrast to a 1 in 9 risk for women.
- Australian Institute of Health and Wellness statistics show that in 2007, breast cancer was the second most common cancer causing death in women, after lung cancer.
- However, if the cancer is limited to the breast, 98% of these women will still be alive five years after diagnosis, excluding those who die from non-cancer related reasons.
- Risk factors for breast cancer include:
- Increasing age
- A family history of breast cancer
- Inherited mutations in the genes BRCA2, BRCA1 and CHEK2
- Obesity which is related to poor diet and lack of physical activity
- Excessive alcohol intake.
- BreastScreen Australia, the national program for early detection of breast cancer funded by the Commonwealth, recommends women aged 50-70 have a mammogram every two years. Women aged 40 onwards are eligible for the program.
Read the study
Bell RJ Lijovic M Fradkin P et al. Lack of Knowledge of Hormone Receptor Status and Use of Endocrine Therapy in Invasive Breast Cancer. Journal of Women's Health. 2009 Dec; 18(12): 1975-1980. Abstract available here.
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