Against All Odds

It might be a common disease, but thanks to early diagnosis and new, effective treatments, more and more women are beating breast cancer. Anne-Marie Mauger talks to Dr Louise Gaunt, consultant radiologist at the PEH.

Sheila Leach is living proof that more and more women are surviving breast cancer - she was diagnosed with the disease more than 30 years ago, and today she is healthy, vibrant and unafraid of 'the big C'.

"Cancer is a scary word, but I know more than anyone, that you don't have to be afraid. Being breast aware is important because early diagnosis helps, but the treatments are so much better today. You have every reason to believe you can come through it. I did."

Dr Louise Gaunt, Consultant Radiologist at the Princess Elizabeth Hospital, agrees that for the vast majority of women, breast cancer is no longer a death sentence.

"This is due to the fact that the disease is now detected much earlier; there's increased breast awareness and the way in which women are treated. There is a 10-15 year survival rate for breast cancer now, which speaks for itself in how effective treatments are," she says.

Despite such optimistic results, a recent study conducted by doctors at Guy's, King's and St Thomas' medical school in London found that out of 546 women, just over half said they would seek medical advice straight away, while the remainder would wait, some for up to two months or more. Dr Gaunt is keen to stress that you should see your doctor as soon as possible if you find a lump. "Seek medical advice sooner rather than later," says Dr Gaunt. "For many women, it may just be normal changes in their breast tissue and they can be quickly reassured that it's nothing to worry about, even if they have to come in to the clinic and have a mammogram. If you do have breast cancer, the earlier diagnosis takes place, the better it is; early treatment increases your long-term survival."

Two other factors play an important part in deciding when you should see your doctor - your age and your menstrual cycle.  If a premenstrual woman finds a lump before her period, she should wait; if it's still there afterwards, she should seek advice. If a post-menopausual woman finds one, she I should definitely seek I advice," she says. Breast cancer I affects one woman in nine during her lifetime in the UK and if a I woman does find a lump, it could have I been through one of I two routes. "She either feels a lump herself, which would be symptomatic, or she is diagnosed through the breast-screening service," says Dr Gaunt. "If she goes to her GP, she is referred to a surgical outpatient clinic, and after that she would see me in the breast unit for a mammography biopsy."

The results are read in Southampton, and if there's an abnormality, the patient will return to the hospital. A biopsy will then be done and these results are sent to the pathology unit over here. "Every week, the whole team meet to discuss every pathology and the ladies come back to see the surgeon for their results," says Dr Gaunt. "Then, once a diagnosis is made, a route is discussed for treatment."

This could follow one of three different paths - surgery, radiotherapy (which involves using X-rays) or chemotherapy (where you take drugs, either in the form of tablets or intravenous drugs). If someone needs to have surgery - the majority of which is done here or in Winchester - they will only have to wait a couple of weeks for it. "It's just a couple of weeks between diagnosis and surgery," says Dr Gaunt. "That is our goal - to get them into hospital in that time. If it's radiotherapy, it takes a bit longer as it's done in the UK," she adds.

Advances in drug therapies are promising - at present, tamoxifen is the most widely used treatment, but local patients are also taking part in a new multi-centre trial that's examining whether a newer drug, exemastane, has superior long-term benefits to tamoxifen. "We probably won't know the answer for about five years though," says Dr Gaunt.

Like in the UK, screening is offered every two years to all women between the ages of 50 and 75 years and "there's a 95% uptake rate here," says Dr Gaunt. Women can then choose to stay in the screening programme beyond this age group - "quite a lot do still come for screening," says Dr Gaunt. It's up to younger women to examine their breasts on a regular basis, but fortunately, the incidence of breast cancer is much lower in this age group. As with any illness, there are a number of women who are at a greater risk of contracting the disease. "There is a small group of women who have a genetic predisposition and they are referred for genetic counseling - here, they talk about the woman's family tree and use that to roughly predict the lifetime risk."

(Reproduced courtesy 24Se7en magazine)

Article from Issue 19 dated Friday 03 October to Thursday 09 October 2003

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