Tracking breast cancer in the Far North
A James Cook University medical student is researching what factors influence the survival of breast cancer victims in Far North Queensland, where there is a higher than national average mortality rate for the disease.
Sixth year medical student, Albert Ho-Huynh’s honours research project is also exploring how to predict the recurrence of breast cancer in patients within the region.
The current survival rate for breast cancer is 90 percent for the first five years, Australia-wide, but the figure drops to 86-87 percent in Far North Queensland.
Mr Ho-Huynh is examining the case files of 900 women treated for breast cancer at Cairns Hospital, between 1999 and 2013, to identify common factors that affect survival rates. Past research indicates that geographical location and ethnicity both play a significant role.
“Compared to Queensland as a whole, the Far North has a significantly higher Aboriginal and Torres Strait Islander population,” he said. “The survival rate for Aboriginal and Torres Strait Islander women with breast cancer is 81 percent, well below the average.
“We have a significantly larger number of people who live in rural and remote areas. Studies have shown that people in such areas tend to have worse outcomes than urban populations, because their location affects their access to diagnostic interventions and treatment.”
The researcher is also investigating whether treatment decisions affect survival rates in Far North Queensland.
“International studies indicate breast conserving surgery (which removes the tumour, but not the entire breast), when combined with radiotherapy, delivers equivalent outcomes to a mastectomy, (total removal of the breast),” he said.
“However, that is not consistent with Australian findings, which have found that people who have a mastectomy have a higher mortality rate.
“But the Australian studies do not appear to factor in the decision-making process; whether the patient’s disease may have been so advanced that a mastectomy was the only option. That’s something we are exploring in our FNQ research.”
A 2004 study showed that women in Far North Queensland were more likely to opt for a mastectomy (55 percent), as opposed to breast conserving surgery, in conjunction with radiotherapy (45 percent).
There are no national statistics to compare the treatment choices, but a South Australian study in 2014 found that 64.5 percent of patients in major cities chose breast conserving surgery. Geographical isolation may sway women in Far North Queensland to choose a mastectomy.
“It may be that if they live in a rural area, they decide not to have breast conserving surgery, because they are further away from a radiation centre where they can receive subsequent treatment,” Mr Ho-Huynh said.
He hopes that his study, due to be completed by the end of 2018, will assist the individual treatment choices of women with breast cancer in the Far North, and also help shape government policies, in relation to the funding of relevant healthcare services in the region.
“We want to improve the breast cancer outcomes for everyone,” he said.