Breast cancer screening should remain a high priority

Early detection is crucial in helping women win the fight against breast cancer.

The decision last week by BreastScreen NSW to suspend all routine breast screening across the state to allow staff to help manage COVID-19 appears to be shortsighted.

Breast cancer specialists have reported that the closure of routine screening services last year led to delays in the detection and treatment of cancers. A six-month delay can mean the difference between less-invasive surgery and a mastectomy and the need for more extensive radiotherapy or chemotherapy.

Professor Fran Boyle, a breast cancer expert from the University of Sydney, says that after routine screening services were suspended during last year’s lockdown, women started presenting with larger breast cancers by the end of the year. Many were overwhelmed with a feeling of regret.

The Radiation Therapy Advisory Group (RTAG), an alliance of cancer patient advocates, healthcare providers, medical technology vendors and oncology professionals, released a report this week that highlighted the risks of delayed screening and breast cancer diagnosis. It says Australian health experts anticipate that when normal screening services resume, “patients will present with more advanced cancers because they missed screenings and went undiagnosed”.

The report says there were 145,000 fewer mammograms in Australia between January to June last year compared with the same period in 2018. Screening rates dropped by 37 per cent during Victoria’s lockdown last year and breast cancer surgeries fell by 33 per cent.

NSW Police Minister David Elliott, whose wife Nicole survived breast cancer, knows the importance of early detection and is urging the state government to reopen the breast screening services. Labor MP Sophie Cotsis, who has also been successfully treated for breast cancer, is also behind the push to reopen services. She says that “closing breast screen clinics is appalling and is playing with women’s lives”.

Leaders in the breast cancer field including Professor John Boyages, who has run breast cancer services at Westmead Hospital and across the state as a former director for BreastScreen NSW, believes the temporary closure of screening services is an “overreaction”. He says that breast screening is no different from the delivery of other radiology or GP services, in terms of managing safety and COVID-19 infection control.

Professor Boyages has stressed the importance of prioritising breast cancer which is one of the most common causes of cancer death in women.

Professor Boyle, who is president of the Clinical Oncology Society of Australia, has suggested there should be a pathway for vaccinated patients and health professionals to access breast screening. This sounds reasonable.