Breast cancer

This policy was developed by Cancer Council Australia’s expert Cancer Screening and Immunisation Committee and endorsed by its principal Public Health Committee. This policy was originally published in 2014 and is currently under review.

For updates and to be notified when this chapter is published please contact Amanda McAtamney.

Recently, Cancer Council Australia launched outcomes and findings from the Roadmap for Optimising Screening in Australia - Breast Project (ROSA). ROSA aimed to explore options for potential risk-based breast cancer screening in Australia.

Breast cancer is the most commonly diagnosed cancer (excluding non-melanoma skin cancer) and the second most common cause of cancer death in Australian women^[1]. One in eight women in Australia will be diagnosed with breast cancer by the age of 85^[1]. Breast cancer incidence in Australian women has increased significantly over the past 30 years, however death rates have fallen significantly over the same period^[2].

Population-based mammography screening for breast cancer was introduced in Australia from 1991 to 1995 through the BreastScreen Australia program. Access to BreastScreen Australia by Australian women is determined by age alone. The program is targeted specifically at well women with no symptoms aged 50–69 years; with the target group being extended to women aged 70–74 from 2013.

The introduction of BreastScreen Australia was associated with a particularly sharp increase in breast cancer diagnoses between 1990 and 1995. The rate of diagnosis has remained relatively stable since 1995, when the program became fully operational, and is projected to remain so until 2020^[3][4].

In the 20 years after the implementation of BreastScreen Australia breast cancer mortality rates decreased by 37% among women aged 50–69 years, the target age range for screening during that period^[5]. The decrease in mortality has been attributed in part to increased early detection through screening, and in part to advances in management and treatment^[6][7].

There has been much discussion on the potential benefits and harms associated with population-based mammography screening. While there is debate about the extent of the harms associated with screening, particularly in relation to overdiagnosis, evidence of benefits is generally considered to outweigh the harms in 50–69 year old women^[6].

This chapter of the National Cancer Prevention Policy outlines the impact of breast cancer in Australia and breast cancer risk factors, presents the evidence around population-based mammography screening for breast cancer, including information on the potential benefits and harms of screening, outlines the current policy context in Australia, and outlines a number of policy priorities to reduce the breast cancer burden in Australia.