Download Update on Breast Cancer in New Zealand: a Rural Perspective

Update on Breast Cancer in New Zealand: a Rural Perspective
Presenter: Dr Vanessa Blair, General and Breast Surgeon
Synopsis:
Advances in breast cancer management in recent decades has resulted in a 5 year survival
rate of 86%. This improvement relates to several factors including breast screening, better
treatments (surgery, chemotherapy, radiotherapy and hormone therapy) and greater patient
awareness. Despite this positive trend, there is emerging evidence of disparities in outcomes
– with data showing breast cancer survival is less in socially deprived groups, certain
ethnicities (Maori and Pacific peoples) and when comparing New Zealand with Australia.
Epidemiological literature on breast cancer in ‘rural women’ as a subset of the New Zealand
population is sparse.
When dealing with a breast cancer diagnosis, the reality of long distances (either from
treatment providers and/or from a patient’s support networks when treatment takes place
away from home) can add to the difficulties and stresses women and their families face.
Doctors, Nurses and other allied health professionals need to be aware of these difficulties
as they have the potential to impact on treatment decisions.
For example, rural women are more inclined to choose a mastectomy over breast
conserving surgery in order to avoid radiotherapy. The standard 5 week course of
radiotherapy is only provided at six centres in New Zealand (Auckland, Hamilton, Palmerston
North, Wellington, Christchurch and Dunedin) It is important that these women receive
accurate information about the supports available to them (see list below) and local breast
cancer networks, to help them reach a decision that is right for them and their families.
There have been many advances in breast cancer care in the last 10-20 years. These
advances will be reviewed, focusing on the relevance to cancer practice in rural and remote
locations and the impact on patients. These include the availability of sentinal node biopsy,
reconstructive options and access to them, and hereditary factors, in the identification and
management of high risk patients. Evidence around intra-operative radiotherapy
(Intrabeam), now available in the private sector in Auckland –will be discussed as another
option for rural women to consider.
Support services for rural women
The National Transport Assistance Programme.
BreastScreen Aotearoa provision of accommodation for families
New Zealand Breast Cancer Foundation = cars, research