Age and size of tumour big factors in survival
Adam Creswell - The Australian
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SURVIVING breast cancer is strongly linked to age and how big the tumour is by the time the disease is diagnosed, according to new research underlining the importance of screening programs in early detection.
The first national report linking breast cancer survival to tumour size, based on results from more than 10,000 Australian women, has found a woman's chance of being alive five years after a breast cancer diagnosis is high if the tumour is less than 10 millimetres in diameter when it is detected.
Survival rates decline drastically as tumour size increases. At the same time, women aged under 40 face lower survival rates compared with older women.
Women aged 50 to 59 had a 90 per cent chance of being alive five years later, irrespective of tumour size - but this rate was 86 per cent for women in their 30s and younger, according to the report published today by the Australian Institute of Health and Welfare.
Helen Zorbas, director of the National Breast Cancer Centre, which commissioned the report and assisted in analysing the data, said the findings showed younger women tended to develop more aggressive tumours. More research was required to find out why this was so and what could be done about it.
Dr Zorbas said cancer in many younger women had "more aggressive features", which reduced that age group's survival chances.
"There's a lot of research effort being put into identifying these features, and to target therapies so we are treating them in a more individual way and perhaps a more aggressive way," Dr Zorbas said.
The report shows that when a tumour measured 10mm or less across, the survival rate was 98per cent after five years - almost the same as for women without cancer. However, survival rates declined according to tumour size: to 95 per cent for women with 11-15mm tumours, 93per cent for 16-19mm and 88 per cent for 20-29mm .
By the time the tumour had grown to more than 30mm, the survival rate after five years fell to 73 per cent, and to just 49 per cent for tumours of unknown size.
Dr Zorbas said the report was an important document "in that it gives us real data on the impact of early detection on survival".
"This is the first time that we have had national data that looks at survival and relates it to the size of the tumour," she said.
"It's an empowering report for women, in that it tells them that much of the early detection is in their hands, and they can use that information to improve their outcomes from disease. The 'breast awareness' message is a really important one, and (the importance of) attending breast screening is a really important message."
Australian guidelines recommend women aged 50 to 69 undergo screening every two years.
Dr Zorbas said another concern was that survival was significantly lower for women from lower socio-economic groups.
Although women in the wealthiest 20 per cent of the population had a five-year survival rate of 89per cent, this fell to 86 per cent in the middle 20per cent band and 84 per cent in the lowest band.
One explanation was a lower participation rate in breast cancer screening by women in these lower socio-economic groups.
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