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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: [email protected]
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