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This systematic review examines variations in outcomes along the breast cancer continuum for Australian women by Indigenous status. Multiple databases were systematically searched for peer-reviewed articles published from 1 January 1990 to 1 March 2015 focussing on adult female breast cancer patients in Australia and assessing survival, patient and tumour characteristics, diagnosis and treatment by Indigenous status. Sixteen quantitative studies were included with 12 rated high, 3 moderate and 1 as low quality. No eligible studies on referral, treatment choices, completion or follow-up were retrieved. Indigenous women had poorer survival most likely reflecting geographical isolation, advanced disease, patterns of care, comorbidities and disadvantage. They were also more likely to be diagnosed when younger, have advanced disease or comorbidities, reside in disadvantaged or remote areas, and less likely to undergo mammographic screening or surgery. Despite wide heterogeneity across studies, an overall pattern of poorer survival for Indigenous women and variations along the breast cancer continuum of care was evident. The predominance of state-specific studies and small numbers of included Indigenous women made forming a national perspective difficult. The review highlighted the need to improve Indigenous identification in cancer registries and administrative databases and identified key gaps notably the lack of qualitative studies in current literature. [ABSTRACT FROM AUTHOR]

Abstract: International research suggests complementary therapy usage is common in women with breast cancer. Comparable data do not exist for Australia. A self-completed questionnaire was used to survey Australian women with breast cancer about their usage of complementary therapies. The survey was mailed to members of two breast cancer consumer advocacy groups, and assessed type of therapy used, reasons for use, and sources of information about complementary therapies. Of 367 respondents with breast cancer, 87.5% had used complementary therapies, with many using four or more therapies. Most commonly used were vitamin supplements (54.2%), support groups (49.8%), massage (41.4%) and meditation (38.7%). Common reasons for use included improving physical (86.3%) and emotional (83.2%) wellbeing and boosting the immune system (68.8%). Women sought information about complementary therapies from a variety of sources. The range of therapies used and the diverse reasons for use emphasise the need for reliable, evidence-based information about complementary therapies for women and clinicians. [Copyright &y& Elsevier]

Purpose: Evidence-based guidelines assist clinicians to integrate research into practice. National Breast and Ovarian Cancer Centre (NBOCC) has systematically reviewed current evidence and developed recommendations for staging and managing the axilla in early breast cancer (EBC). NBOCC guidelines for sentinel node biopsy (SNB) were presented at RACS in 2008, supporting SNB as an alternative to axillary dissection (AD) in suitable women with EBC. However, guidelines for non-SNB-based axillary management are also required. Methodology: A multidisciplinary working group including consumers oversaw the systematic review addressing: AD versus 4-node sampling in axillary staging; AD versus non-surgical methods in axillary staging; the optimal extent of AD; the prognostic significance of the number of nodes retrieved and the proportion of involved nodes identified at AD; long-term outcomes of AD; and axillary irradiation (with or without AD) following breast surgery. Evaluation of the evidence informed the development of guideline recommendations by the working group. Results: Eleven randomised trials were identified, however the majority of evidence was from non-randomised trials. Imaging alone is not recommended for routine staging, and for most patients, surgical staging of the axilla is required. For women undergoing AD, level I or II AD is recommended. For women in whom axillary dissection is contraindicated, radiotherapy of the axilla is recommended. Implications and further recommendations for clinical practice will be discussed. Conclusion: Guidance for clinical practice is vital where evidence is inconsistent. Axilla management in EBC is once such area, emphasising the importance of new NBOCC guidelines. [ABSTRACT FROM AUTHOR]

A scoping study of breast imaging reporting in July 2006 by the National Breast Cancer Centre (NBCC) revealed that synoptic reporting has not been widely implemented in Australia. The 2002 NBCC publication Breast imaging: a guide for practice recommended the use of a breast imaging synoptic report. A synoptic report contains a summary of essential information in a checklist format with standard language, descriptions and classification system (i). Synoptic reporting may improve the content and completeness of reports, reduce the risk of misinterpretation of findings, improve communication between referring clinicians and radiologists and facilitate the transfer of information to databases for quality improvement activities and audit (i). A breast imaging synoptic report helps clinicians and patients by assisting in tracking individual lesions, ensuring the inclusion of mammographic and ultrasound characteristics of lesions, offering one classification per lesion and a combined imaging diagnosis. As a result of the scoping study, the breast imaging synoptic report has been revised by a multidisciplinary working group to ensure acceptability and applicability to radiologists, referring clinicians and end users. A number of strategies have been identified to assist the implementation of the revised NBCC breast imaging synoptic report and standard classification system. Surgeons as referrers and end users, play an integral role in advocating and promoting the use of synoptic reporting in breast imaging. (i) National Breast Cancer Centre. Breast imaging: a guide for practice. Camperdown, NSW: National Breast Cancer Centre, 2002. [ABSTRACT FROM AUTHOR]

In Australia there is currently no consistent approach to collecting breast cancer specific data. The National Health Data Dictionary (NHDD) recommends a core set of generic data items for clinical cancer registration. However this list does not include the more detailed items required by specific tumour streams. The NBCC has developed a supplementary set of Breast Specific Data Items and definitions to serve as a guide for specialist breast cancer data collection in Australia. A multidisciplinary Working Group comprising clinical and consumer representation, including three breast surgeons, identified 16 breast specific data items for collection. The items are designed to align with items collected through the RACS National Breast Cancer Audit and leading cancer centres. A range of items from patient data (menopausal status), diagnostic data (HER2 status, sentinel lymph node), treatment (surgical margin clearance and involvement), and breast reconstruction are included. The data items are recommended as best practice for breast cancer specific data collection and aim to facilitate national consistency in defining, recording, and monitoring information about patients with breast cancer. This national approach will contribute to improved patient outcomes by informing planning, quality improvement and evaluation strategies for cancer services. The items are currently being piloted in two sites in NSW and will be available nationally in late 2007. [ABSTRACT FROM AUTHOR]