BREAST CANCER TREATMENTS FOR WAIKATO WOMEN WITH NEWLY 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 population database of breast cancer diagnosed since 2005. Overall, the outcomes for women with newly diagnosed breast cancer in New Zealand is relatively good. Despite this, women in New Zealand still face a 20% greater chance of dying from breast cancer compared to women 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 later stage at presentation, Maori and Pacific Island women are requiring more aggressive treatment; including higher mastectomy and adjuvant chemotherapy 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 and symptomatic presentations. Data is also collected relating to surgical procedures and adjuvant treatments including any chemotherapy, radiotherapy or endocrine therapies prescribed. 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 undergoing mastectomy were also given radiotherapy. A higher proportion of Maori and Pacific Island women received chemotherapy, reflecting a higher stage of disease in this population group Endocrine/Biological Therapy (as a % of Endocrine responsive/ Her2 +ve Women) 0% 5% 10% 15% 20% 25% 30% 35% 40% Tamoxifen Alone (n=222) Aromatase Inhibitor Alone(n=294) Mixed Therapy (n=145) Declined (n=20) Not Offered (n=140) Biological (Transtuzumab) Therapy (61) Her2 +ve Endocrine