THE FUTURE: ‘We can advance targeted treatment even further’

In 25 years, a blood test taken at birth could indicate whether a baby will be at high risk of getting breast cancer later on in life.

At the moment, New Zealand women discover breast cancer after feeling a lump or being picked up in the screening programme from the age of 45 years.

“We can identify to a degree women who are at higher risk due to family history but in the future we are hoping to refine that with genetic testing done at birth,” Auckland breast cancer surgeon Eletha Taylor said.

This would mean people who are at high risk of getting breast cancer could get earlier and more frequent screening or could even be screened in a different way, such as a blood test, rather than through imaging, Taylor said.

“And some people may have a very low risk of getting breast cancer so may not need screening as frequently.

“At the moment we have a one-size fits all approach but in the future we hope it make screening more personalised based on risk,” Taylor said.

But this type of testing is still a long way of becoming a reality.

“Research is still very much at the early stages but some of the technology that could make it possible is there,” Taylor said.

Collecting as much genetic data from as many New Zealand women diagnosed with breast cancer as possible was the first step.

Already if a New Zealander has a family member with breast cancer, they can get a blood test to see if they have inherited the harmful mutation and have an increased risk of developing the deadly disease.

If the mutation is present, that indicates the person has inherited it from their parent and may pass it on to their own children even if they don’t develop cancer themselves.

The result also means their full siblings have a 50 per cent chance of having the mutation.

Diagnosing cancer will become easier with the development of a liquid biopsy to give an exact profile of the tumour.

“This will mean we can advance targeted treatment even further.”

Taylor said neoadjuvant therapy (NAT) — chemotherapy before surgery — will likely become more common after trials are conducted in Christchurch and Auckland.

The Breast Cancer Foundation last year funded the pilot of a neoadjuvant clinic at Auckland City Hospital, which has led to a drop in time to treatment for patients and enabled new drug treatments to be introduced for patients with high-risk breast cancers.

“The next stage is looking at whether there is a group of people who won’t need surgery at all,” Taylor said.

“It used to be every woman diagnosed got a full mastectomy and all lymph nodes removed and that moved to a part mastectomy and some lymph nodes.

“Hopefully, we will see that trend continue so women can potentially avoid surgery altogether and tailor treatments to each individual women.

“It’s exciting.”

Hopefully . . . women can potentially avoid surgery altogether Eletha Taylor breast cancer surgeon