Objective: Breast cancer accounts for 28% of all new cancers in Australian Women1. Cancer patients in regional Victoria have poorer outcomes compared to their metropolitan counterparts. We conducted a clinical audit on breast cancer patients presented at Goulburn Valley Health (GVH) to describe their clinical presentations, treatment and outcomes.
Method: This is a retrospective study conducted at GVH Oncology Unit from 1st February 2012 to 30th September 2014. Approval was obtained from the ethics committee.
Results:
A total of 191 patients with breast cancer were identified from the hospital electronic medical records. Majority (n=118) were newly diagnosed, nearly a quarter (n=45) had their care transferred to GVH and the remaining (n=28) developed recurrence. Fifty-four (28%) patients were detected through screening mammography. Majority were referred by surgeons (54%), followed by physicians (17%), general practitioners (13%) and other specialists (16%). 29% of patients presented with stage 1 disease, 34% stage 2, 14% stage 3 and 23% stage 4 disease. Most patients with non-metastatic disease (93%) underwent surgery whereby 63% had mastectomy with 7 patients having bilateral mastectomies. Nearly two thirds (n=123) received either chemotherapy and/or radiotherapy (n=117). 85% received endocrine therapy while 18% (n=34) had HER2-positive disease of whom 31 received trastuzumab-based treatment. 12 of the 13 patients who died presented with advanced disease while 1 died of non cancer-related cause. The follow up, relapse-free and overall survival rates will be updated.
Conclusion: Despite a limited sample size in a retrospective cohort, screen-detected breast cancer rates were lower compared to state averagefrom BreastScreen Victoria3. As expected, more patients presented late and with metastatic disease. Patients followed up only by surgeons or other specialists are not included in our cohort. Analysis of our data may shed light to help optimise outcomes of breast cancer in regional Victoria.