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Wednesday, 10 October 2012
Page: 7809

Senator POLLEY (TasmaniaDeputy Government Whip in the Senate) (12:45): October is Breast Cancer Awareness Month. When the late Mrs Evelyn H Lauder, co-creator of the pink ribbon, launched the Estee Lauder company's breast cancer awareness campaign in 1992, she dreamt of a world without breast cancer. At this time breast cancer was a disease that was rarely talked about. Women who were diagnosed were terrified and, in some cultures, even ashamed or outcasts. Twenty years later information about breast cancer and breast health, and the knowledge that early detection saves lives, is far more prevalent and discussed regularly thanks to Evelyn. She was relentless in her determination to spread breast cancer awareness to as many people as possible in as many places as possible. She impacted on countless women and men with her bold vision for a breast cancer free world. This vision lives on in the hearts of many, including my own.

If we look to India, while the world debates whether women should be regularly checked for breast cancer from 40 to 50 years, the union health ministry in a landmark step has decided to start screening from 30. Is this a page we should be taking from their book? I leave you with that question to ponder. The incidence of breast cancer in Japan, Singapore, South Korea and India is three times what it was 40 years ago. It is known that in those countries, if detected early, breast cancer is curable and survivor rates are around 90 per cent.

Breast cancer cases are surging across the globe. A global analysis over the past three decades shows the number of new breast cancer cases diagnosed worldwide has increased dramatically from about 6.4 in 100,000 in 1980 to 16 in 100,000 in 2010. The rise in deaths from breast cancer globally has been much slower, increasing from about 2.5 in 100,000 in 1980 to 4.25 in 100,000 in 2010, reflecting the effectiveness of early detection and advancements in treatment, particularly in developed countries.

A report from the Australian Institute of Health and Welfare and Cancer Australia shows that more than 13,000 women were diagnosed with the disease in 2008. That was about 37 women each day and the report says the number of women diagnosed with breast cancer in Australia each year is expected to rise to more than 17,000 by 2020. Let us look at this in more detail. One in nine will be diagnosed with breast cancer before the age of 85. Currently in Australia 36 more women are diagnosed with breast cancer every day. Breast cancer is the most common cancer among Australian women, accounting for 28 per cent of all cancers diagnosed in 2006. By 2015, the number of new breast cancer cases among women is projected to be 22 per cent higher than in 2006, with an estimated 15,409 women expected to be diagnosed with breast cancer. This is in line with the estimate of the Australian Institute of Health and Welfare and Cancer Australia. Breast cancer is the most common cancer experienced by Aboriginal and Torres Strait Islander women. Indigenous women were significantly less likely to be diagnosed with breast cancer than non-Indigenous women between 2002 and 2006. That was 69 and 103 new cases per 100,000 women respectively.

The risk of breast cancer increases with age. About 24 per cent of new breast cancer cases diagnosed in 2006 were in women younger than 50 years; 51 per cent were in women aged 50 to 69 and 25 per cent were in women aged 70 and above. The age standardisation incident rate has increased from 80.7 in 1982 to 112.4 in 2006. The highest age standardised incidence rate occurred in the ACT with 129.6 cases per 100,00, followed by Western Australia with 114.9, Tasmania with 114.8, Queensland with 114.6, South Australia with 113.5, New South Wales with 113.1, Victoria with 111.4 and the Northern Territory with 83.3.

What do we know about changes in mortality rates? Breast cancer and lung cancer are the two leading causes of cancer related death in Australian women. Lung cancer claimed 65 more lives than breast cancer in 2006. There were 2,618 female deaths from breast cancer in 2006. A woman's risk of dying from breast cancer before the age of 85 declined from a one in 30 risk in 1982 to a one in 38 risk in 2006. The age standardised rate of death due to breast cancer amongst women fell from 30.2 deaths per 100,000 females in 1994 to 22.1 deaths per 100,000 females in 2006, a decrease of 27 per cent. Mortality rates for Indigenous women in Queensland, Western Australia, South Australia and the Northern Territory were not significantly different from those of their non-Indigenous counterparts—25 and 23 deaths respectively per 100,000 women. Australia's death rate from breast cancer was significantly lower than the rates for New Zealand, northern Europe, western Europe and western Africa.

On the positive side of survival for women, there was an increase in relative survival from diagnosis of breast cancer between 1982 to 1987 and 2000 to 2006. The five-year relative survival increased from 72.6 per cent to 88.3 per cent respectively. In 2006, the five-year relative survival rate was 98.2 per cent for women, with zero to 10-millimetre tumours. It was 94.7 per cent for women with 11- to 15-millimetre tumours, 93 per cent for women with 16- to 19-millimetre tumours, 87.9 per cent for women with 20- to 29-millimetre tumours and 73.1 per cent for women with tumours 30 millimetres or greater.

I would now like to briefly talk further about cancer. It is important to reiterate that, as Evelyn Lauder suggested and Maureen Case noted:

Every woman goes into her mammography with the fear of finding a lump, but the mammograms of 10 years ago aren't the mammograms of today … I hope to help women breathe a bit easier when they find out about these things. I also hope to give a voice to the critical, life-saving awareness message that early detection can indeed save lives; I believe that especially during this 20th Anniversary of The Breast Cancer Awareness Campaign, Evelyn Lauder would want not just me, but all of us to serve as this voice.

All women need to be aware of the risk factors. A risk factor is anything that increases the possibility of getting the disease. Different cancers have different risk factors. For example, we know that exposing skin to strong sunlight is a risk factor for developing skin cancer and that smoking is a risk factor for cancers of the lungs, mouth, larynx, bladder, kidney, and several other organs. Having one or more risk factors does not mean that a woman will definitely develop breast cancer but it might increase her chance of developing breast cancer. Some women with one or more risk factors might never develop breast cancer. Some risk factors like gender, age or race cannot be changed. Some of the risk factors influence the likelihood of developing breast cancer more than other risk factors. The risk of developing breast cancer can change over time.

The main risk factors for developing breast cancer appear to be being female—men can get breast cancer but it is rare and accounts for less than one per cent of all breast cancers; having a strong family history of breast cancer—however, the majority of people who are diagnosed have no known family history; inheriting a faulty gene that increases the risk of breast cancer; and having previously been diagnosed with breast cancer. There are other factors that we should also consider. These other factors that seem to slightly increase a woman's risk of developing breast cancer include starting menstruation at a relatively early age—before the age of 12; starting menopause at a relatively late age—after 55 years; not having children or having a first child after the age of 30; not breastfeeding—the more months spent breastfeeding, the lower the risk of developing breast cancer; taking combined hormone replacement therapy after menopause, especially for five years or longer; gaining a lot of weight in adulthood, especially after menopause; and drinking alcohol, if you drink more than two standard drinks a day.

There are many levels of breast cancer. I do not intend to discuss all these in detail other than to emphasise that early diagnosis cannot be overstressed. For those women who have a mammogram, having been in the position myself of having something come back that is abnormal, I understand that feeling you get in your gut that this could be it—that the time bomb could be going off. The necessity of having follow-up examinations and scans is critical. Having been through that, when I had to wait 10 days for a scan, I had everything planned out. I was not very optimistic. I had planned my funeral and updated my will. But that is not necessary because early detection can give you a far greater chance of beating the disease.

We know early breast cancer can be contained in the breast but it may also spread to the lymph nodes in the breast and the armpits. Locally advanced breast cancer is where the cancer has spread to one or more of the lymph nodes or other areas near the breast or to tissues around the breast such as the skin, muscle or ribs but there is no sign that it has spread to other parts of the body. Secondary breast cancer is the term used to describe cancer that has spread from the original site in the breast to other organs or tissues in the body. Once again I cannot stress enough the need to have regular mammograms and self-examination.

The Breast Cancer Network Australia, or BCNA, has produced the My Journey Kit—a comprehensive resource kit for women who have been recently diagnosed with breast cancer. The kit consists of three main elements: the My Journey Information Guide which is fantastic—and I encourage those listening, particularly those in the chamber, to promote this on your websites; the My Journey Personal Record for recording contact details, personal information, notes and important dates and a place to store test results; and a range of brochures including the Beacon, a free quarterly publication of the BCNA. Another excellent resource produced by the Breast Cancer Network Australia is a resource for women with secondary breast cancer called the Hope & Hurdles pack. The pack contains a number of individual items: booklets, brochures, magazines and CDs that offer information, support and hope to women and their families. Breast Cancer Network Australia also distributes the Inside Story, a supplement to the Beacon targeted specifically at people experiencing secondary cancer. It includes personal stories, support, information and resources.

The breast cancer awareness campaign is devoted to defeating breast cancer through education and medical research. Another notable organisation helping the fight against breast cancer since 2008 is the McGrath Foundation. Their support helped more than 16,000 Australian families experiencing breast cancer with 77 McGrath Breast Care Nurses working in communities right across Australia. Their goal is to reach 150 McGrath Breast Care Nurses to ensure that every Australian family experiencing breast cancer has access to the support they need—and I emphasise: this disease, like every form of cancer, affects not just individuals but their families as well.

While many women regularly maintain their breast screening there are also many women who are less careful. I commend the work of all those organisations and individuals out there in our community raising awareness and advocating for women to be vigilant in their self-care. I congratulate again those two organisations I have spoken about because they have certainly raised the profile of breast cancer in this country.

But there is something that we should look at: should we, indeed, be starting to screen women at 30? That is a question we should be pondering and I look forward with anticipation to see what our researchers and medical professionals have to say on this.

I would also like to take the opportunity to thank Mrs Evelyn Lauder for her initiative in moving forward with this campaign. As I said, it is something that we should celebrate, because it has been a very successful campaign. We have not beaten the disease but I think that in terms of public awareness we are well on our way to ensuring that women do take better care of themselves.

This message is for all women. They are our mums, they are our sisters, they are our aunts, they are our cousins and they are our friends. As I said, men can also get breast cancer and, though it accounts for less than one per cent of all breast cancers, men should also be keenly aware of this disease.

I would also like to place on record my thanks and respect for our researchers and our medical professionals for their tireless work.