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BREAST CANCER TREATMENTS FOR WAIKATO WOMEN WITHNEWLY DIAGNOSED BREAST CANCER 2005 – 2008

Ooi C(*), Ellis S, Campbell I(*), Hamilton MA, Lawrenson R, Kuper M, Round G, Lamont D, Tamatea D.

Waikato Breast Cancer Trust and Breast Care Centre, Waikato Hospital, Hamilton, New Zealand

Surgery

Waikato Breast Cancer Trust

P.O Box 97

Waikato Mail Centre

Hamilton 3240

Phone: (07) 8398726 ext 7916

Fax (07) 8343657

Email: Jenni.scarlet@waikatodhb.health.nz

Oncology

Objectives:The Waikato Breast Cancer Register (WBCR) is a comprehensive regional populationdatabase of breast cancer diagnosed since 2005. Overall, the outcomes for women withnewly diagnosed breast cancer in New Zealand is relatively good. Despite this, women inNew Zealand still face a 20% greater chance of dying from breast cancer compared towomen in Australia. This analysis seeks to examine treatment patterns in Waikato women.It is important to examine reasons why this might be.

Conclusion:Waikato women are receiving the appropriate treatment for their cancer stage. This applies equally to women from all ethnic groups,including Maori women, whose tumours had less favourable prognostic indicators when compared to European women. Because of laterstage at presentation, Maori and Pacific Island women are requiring more aggressive treatment; including higher mastectomy and adjuvantchemotherapy rates.

References:1. Armstrong W, Borman B. Breast cancer in New Zealand: trends, patterns and data quality. NZ Med J 1996:109:221-224

Methods:The database encompasses the breast cancer population for both screening andsymptomatic presentations. Data is also collected relating to surgical procedures andadjuvant treatments including any chemotherapy, radiotherapy or endocrine therapiesprescribed.

Primary Surgical Procedure

by Ethnicity - Invasive

0%

10%

20%

30%

40%

50%

60%

70%

80%

European (n=665) Maori (n=117) Pacific Island

(n=18)

Other (n=17)

Mastectomy WLE No Primary Surgery

Primary Surgical Procedure

by Age - Invasive

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

!29 (5) 30-39 (40) 40-49 (155) 50-59 (212) 60-69 (199) 70-79 (129) 80+ (77)

Mastectomy WLE No Primary Surgery

Primary Surgical Procedure

by Age - In Situ

0%

20%

40%

60%

80%

100%

120%

30-39 (3) 40-49 (35) 50-59 (44) 60-69 (33) 70-79 (4) 80+ (5)

Mastectomy WLE No Primary Surgery

Primary Surgical Procedure

by Invasive or In Situ

0%

10%

20%

30%

40%

50%

60%

70%

Invasive (817) DCIS (124)

Mastectomy WLE No Primary Surgery

Systemic Therapy (Invasive only n=785)

0%

10%

20%

30%

40%

50%

60%

70%

80%

European (647) Maori (107) Pacific Island (15) Other (16)

Yes No Declined Not Recommended

Radiotherapy Treatment

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Mastectomy (384) WLE (374) Mastectomy (32) WLE (76)

Invasive In-situ

Yes No Declined

Primary Surgical Procedure by Tumour

Size (Invasive only, n=817)

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

!2cm (n=443) 2-5cm (n=292) >5cm (n=39)

Mastectomy WLE

Primary Surgical Procedure by

Ethnicity - DCIS

0%

10%

20%

30%

40%

50%

60%

70%

European (n=105) Maori (n=15) Other (n=4)

Mastectomy WLE No Primary Surgery

Consistent with recent trends, 50% of women undergoingmastectomy were also given radiotherapy.

A higher proportion of Maori and Pacific Island womenreceived chemotherapy, reflecting a higher stage of diseasein this population group

Endocrine/Biological Therapy(as a % of Endocrine responsive/ Her2 +ve Women)

0%

5%10%

15%

20%

25%

30%35%

40%T

am

oxifen

Alo

ne

(n

=2

22

)

Aro

ma

tase

Inh

ibito

r

Alo

ne(n

=294)

Mix

ed

Th

era

py

(n=

145)

De

clin

ed

(n

=2

0)

No

t O

ffe

red

(n=

140)

Bio

log

ica

l

(Tra

nstu

zu

ma

b)

Th

era

py (

61

)

Her2 +veEndocrine