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A new set of clinical guidelines for the treatment of
advanced breast cancer (ABC) has launched today, Metastatic
Breast Cancer Awareness Day (13 October).
The 2nd New
Zealand Consensus Guidelines for Advanced Breast Cancer
(ABC-NZ2) were developed by the Breast Special Interest
Group (Breast SIG) – doctors and nurses who specialise in
the treatment of breast cancer – with the assistance of
Breast Cancer Foundation NZ (BCFNZ).
“We’ve
created these guidelines to be a framework for everyone
involved in the treatment of ABC, including clinicians,
patients and government health organisations,” says Dr
Marion Kuper-Hommel, consultant medical oncologist at Te
Whatu Ora Waikato, chair of the Breast SIG and lead
clinician behind ABC-NZ2.
“They provide an
evidence-based summary of what New Zealand clinicians
consider is best practice to manage ABC, which is a complex
disease requiring specialist care, if we are to help our
patients live as long as possible with the best quality of
life. Our mission is to get these guidelines used by all
stakeholders involved with the management of ABC.”
A
report on ABC in Aotearoa New Zealand published by BCFNZ in
2018, “I’m Still Here”, found that some clinicians had
little awareness of international ABC guidelines and did not
find them relevant for the NZ landscape. A priority
recommendation in the report was to produce NZ-specific
guidelines urgently.
“Our research showed Kiwi women
were dying of ABC twice as fast as people in comparable
countries, they were receiving less treatment than those
overseas and many of them felt like the health system had
turned its back on them,” says Ah-Leen Rayner, chief
executive of BCFNZ.
“These updated guidelines will
help doctors to keep up-to-date with the most effective ways
to care for Kiwis with ABC. They’ll also help patients
navigate treatment conversations with their specialists. We
want all patients to receive the same high level of care and
the best treatment that could extend or improve their lives,
no matter where they live,” Rayner adds.
Breast
cancer is the leading cause of death for NZ women under 65.
ABC, also called metastatic, secondary or stage 4 breast
cancer, is where breast cancer has spread to other parts of
the body. Although it isn’t possible to cure ABC,
innovative new treatments can help women live for many years
after their diagnosis. Around 400 Kiwis are diagnosed with
ABC every year.
Treatment for early breast cancer
(before it has metastasised beyond the breast) in NZ is
largely in accordance with Ministry of Health standards and
guidelines, but the treatment pathway for ABC can be much
more varied.
The Breast SIG, with the help of BCFNZ,
created the first ABC–NZ guidelines in late 2020 by
adapting international guidelines and achieving consensus
between 20 breast cancer experts from around the country
including medical oncologists, radiation oncologists, breast
surgeons, ABC clinical nurse specialists, GPs, breast
physicians, palliative care physicians and patient
advocates. The challenges of managing patient care through
the Covid-19 pandemic meant the new guidelines were not
top-of-mind for many, but they are expected to play an
important role moving forward.
The Breast SIG was
established in 2007 with the aims of improving the care of
breast cancer patients throughout NZ and providing advice to
government and non-governmental bodies about innovative
treatments and
technologies.
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