Breast Cancer in Australia and Antarctica

Saachi Mehra and Yash Mehra (Equal contribution),

and Dr Lopamudra Das Roy

Published: October/2023

Abstract

Although there has been a rise in advanced medical technologies, medical care facilities, and research studies, cancer is still affecting many individuals around the world. Through this research, we explored the latest cases of breast cancer in the continents of Australia and Antarctica. With an emphasis on discovering potential differences and similarities between these geographically diverse places, this study intends to evaluate the possible causes, demographic patterns, and clinical surroundings of breast cancer in Australia and Antarctica. The Australian Institute of Health and Welfare, the National cancer institute, and the American Cancer Society were some of the verifiable and reputable sources which we used. As for the graphs and the statistics over the years we used the National cancer institute which provided accurate and detailed information about cancer in our specific regions. Some of the main observations that we have noted are that breast cancer incidence in Antarctica is extremely rare due to the small population and limited exposure to known risk factors. At the same time, Australia has shown a steady increase in cases due to various factors such as age, genetics, and lifestyle even though there is better access to healthcare compared to Antarctica. The study draws attention to the special characteristics of breast cancer in Antarctica, where the incredibly low incidence shows the significance of population size and exposure to risk factors. These results underline the importance of targeted public health initiatives, genetic counseling, and awareness campaigns in various geographic settings, ultimately leading to better breast cancer outcomes globally.

Australia

Cancer Statistics in Australia

Breast Cancer has impacted the lives of many around the world in detrimental ways. There have been many new ways to detect, prevent, and treat breast cancer but, they are never a guarantee. Australia is ranked amongst the highest in the world for having an advanced healthcare system and education, but unfortunately, the diagnostic rate for breast cancer has not shown any signs of slowing down, instead, it has been steadily rising through the years. Over 20,000 Australians are diagnosed each year with breast cancer, which means, there are about 57 people who are diagnosed every day. From the analysis of this data it could be speculated that such a continent which is equipped with resources available to the public can face problems but how is it that even with advanced technology the diagnosis is late? According to a source regarding the Breast Cancer Scenario in Australia explains. Patients who were diagnosed with Breast cancer early had a 92% chance of surviving in comparison to those who had been diagnosed late. In many cases early diagnoses of Breast cancer helped treat the disease more efficiently when compared to late diagnoses which is often difficult to treat with higher mortality rates. It is important to ask why and how Breast cancer is diagnosed. Regional differences can be seen in the incidence and mortality rates of breast cancer in Australia. The more populated eastern states including New South Wales, Victoria, and Queensland often have a greater number of cases of breast cancer, according to data up to 2021. These areas have modern medical facilities, which improves case detection and reporting. On the other hand, less populated regions in the Northern Territory, South Australia, and Western Australia often have lower incidence rates of breast cancer. The pattern may be influenced by elements including geographic isolation, restricted access to healthcare services, and differences in the infrastructure supporting healthcare. Despite these regional variances, breast cancer detection, treatment, and research have advanced significantly in Australia as a whole, leading to higher survival rates. National public screening programs and awareness campaigns have played a crucial role in early detection and improved outcomes. It is essential to continue monitoring and addressing regional disparities to ensure that all Australian women have equal access to breast cancer screening, early diagnosis, and quality treatment regardless of their geographic location. [1]

©BreastCancerHub created by Yash Mehra and Saachi Mehra, Data Source: [27]

Breast cancer is a significant public health concern in Australia, affecting thousands of women each year. While the exact causes of breast cancer remain complex and multifactorial, several risk factors have been identified that can increase the likelihood of developing this disease. Among these risk factors, tobacco use, obesity and physical inactivity, diet and nutrition, sun exposure and skin cancer, occupational hazards, infectious agents, and genetic and family history play critical roles in breast cancer prevention and early detection. Tobacco use is a well-established risk factor for various cancers, including breast cancer. Although the link between smoking and breast cancer is not as strong as with other cancers like lung cancer, smoking has been shown to increase the risk of developing breast cancer, especially in younger women. It is crucial for public health initiatives to continue educating the Australian population about the harmful effects of smoking and to encourage cessation efforts to reduce breast cancer risk. Obesity and physical inactivity are interconnected factors that contribute significantly to breast cancer risk. According to research, postmenopausal women who are overweight or obese have a higher chance of developing breast cancer than those with healthy body weight. Additionally, physical inactivity has been associated with an increased risk of breast cancer. Promoting healthy lifestyle habits, including regular physical activity and maintaining a healthy weight, is essential to reduce breast cancer incidence. An insight into the types of foods Australians eat can give us intel into the how and why. According to a study done on public health in Australia Exploring young Australians’ understanding of sustainable and healthy diets: a qualitative Study shows Poor diet contributes to Australia's 20% of all premature deaths from non-communicable diseases. Since dietary behaviors are the drivers and results of our food systems, current diets contribute to the global burden of Non-communicable diseases, this includes premature mortality from cardiovascular disease, diabetes, and certain types of cancers. Poor diet is one of the leading reasons for a steady rise in cases of Breast Cancer over the years, foods such as fast or fried foods, processed meats, added sugar, and refined carbs are all examples of carcinogens that are widely eaten around the entirety of Australia daily. The average Australian eats fast food approximately twice a week according to a study conducted by NaSSDA study team members from a sample of a total of 8,888 individuals from a secondary school 45.6% of men consumed fast food every week where as 33.7% of women consumed fast food. Furthermore, the study shows that advertising products had led about 52% of individuals to be motivated and buy that specific fast food. Diet and nutrition also play a critical role in breast cancer prevention. Research suggests that a diet rich in fruits, vegetables, whole grains, and lean proteins may help reduce breast cancer risk. Another factor which leads to Breast Cancer is severe sun exposure which commonly leads to skin cancer in many Australians, there are significant health concerns in Australia due to the country's high levels of ultraviolet (UV) radiation. While the link between sun exposure and breast cancer is not well-established, it is essential to raise awareness about the importance of sun protection to prevent skin cancer and promote overall health. Encouraging Australians to adopt sun-safe behaviors, such as wearing protective clothing, using sunscreen, and seeking shade, can help minimize the risk of skin cancer and promote general well-being. Occupational hazards also play a role in breast cancer risk, particularly in certain industries where workers may be exposed to carcinogenic substances. Workplace safety regulations and measures are vital to minimize exposure to hazardous materials and protect workers from potential carcinogens, thus reducing breast cancer risk among the working population. Infectious agents have been implicated in the development of some types of cancer, including breast cancer. While the role of infectious agents in breast cancer is still under investigation, it highlights the importance of maintaining good hygiene practices and getting vaccinated against viruses that may contribute to cancer development. Genetic and family history is a significant risk factor for breast cancer. Women with a family history of the disease, especially if they have first-degree relatives (such as a mother or sister) diagnosed with breast cancer, are at higher risk themselves. Genetic testing and counseling can identify individuals with specific gene mutations (e.g., BRCA1 and BRCA2) associated with an increased risk of breast cancer. Early detection and tailored preventive strategies for high-risk individuals are crucial in reducing breast cancer incidence. To effectively address breast cancer in Australia, comprehensive public health initiatives are needed. These initiatives should focus on awareness campaigns to educate the public about modifiable risk factors such as tobacco use, obesity, physical inactivity, and unhealthy dietary habits. [2,3]

Public Health Campaigns and Awareness programs

To address such risk factors and educate the general population about Breast Cancer, Public Health Campaigns make significant changes. In Australia the available include the following under Breast Cancer Network Australia; Making Metastatic Breast Cancer, Count Campaign Increasing Equity of access to breast reconstruction campaign, Herceptin Campaigns Tykerb campaign, and MRI Screening for High Risk Young Women Breast prostheses subsidy program… and several more. The importance of these programs aids in the detection of cancer cells in an individual. Activities such as regular screening and analysis of MRI scans help individuals be updated on their health conditions before and after treatment. It is also important that these programs are cost-efficient. Breast Cancer Network Australia is seeking increased transparency in elective surgery wait times, decreased out-of-pocket costs in private health care, and provision of information at the right time for those diagnosed with breast cancer to educate and make a reasonable choice regarding breast reconstruction. The program provides for both men and women with all necessary care and informing them about treatment options. One of the biggest goals includes empowering people with Breast Cancer. A survey conducted by Breast Cancer Network Australia reported that reducing the cost of reconstruction, cutting down on wait times in public hospitals, and improving the type of information related to procedures are the changes that most women would like improved. The results from these programs show many drastic changes to the lives of those individuals who received treatment, making it beneficial to look into these. Another part of the Public control campaign about Breast Cancer includes the harmful effects of smoking or using Tobacco. The concern with carcinogens begins with their initial effects on breast cancer, these include the growth of breast tumors, the aggressive spread of the cancer cells through the body, and in addition to that damage to DNA and adduct formation in mammary epithelial cells. Rigorous studies have shown high evidence of the prevalence of carcinogenic chemicals causing DNA adducts and mutations in specific genes such as the p53 gene. Crucial for the regulation and progression of apoptosis, cell cycle, and genomic stability the p53 gene helps protect DNA, additionally the p53 proteins are extremely important as they are tumor suppressors, damaging them leads to major health complications and eventually death in many cases. Mortality rates are significant when many individuals have a high intake of tobacco, while on average, the mortality rate is higher for people who smoke compared to people who don't, the specific association is inconsistent. Some studies found that smoking was a carcinogen and was associated with worse breast cancer-specific survival (BCSS) while others did not. However, many of the reports found a heavy correlation between smoking and a worse prognosis after breast cancer. The importance of addressing this to the patient asserts its damages which tobacco causes to the body, with the intake the survival rate is much lower. By looking more into the science behind these harmful chemicals it helps to know how these things lead to adverse conditions. [4,5,6]

A recent meta-analysis consisting of almost 40,000 patients found that carcinogens such as tobacco and alcohol increase risks of all-cause and breast cancer-specific mortality in patients. Studies reveal that N-acetyltransferase is used in the metabolism and detoxification of drugs through the modification of amine group with an acetyl group. Though there are many dangers, preventative methods include promoting lifestyle changes such as being physically active, wise changes to eating habits, and cutting the intake of intoxicants such as alcohol and tobacco can eventually slow the growth of cancer cells. In 2017 a 12 studies on weight gain after diagnosis of Breast Cancer. It must be understood that diets can vary from person to person as well as metabolic rates. Doing anything rigorous can also lead to complications therefore patients should find a good routine and have a balance of both eating and exercising. Additionally, a continent like Australia is geographically a part of the subtropical high-pressure belt, avoiding harmful sun rays, and wearing sunscreen, hats, etc. is another preventative method for patients diagnosed with breast cancer as long periods of exposure to the sun may cause damage and promote the growth of cancer cells.

Stressing the importance of getting genetic testing of genes such as BRCA1 and BRCA2 can lead to the roots of how cancer cells occurred. Programs such as Parkville Familial Cancer Centre research and explain the idea of pathogenic variations in the detections of the cancer cells, then through their extensive research they enable resources through Genetic testing for eligible patients in a clinical setting. [6,7,8]

Breast Cancer treatments and therapy plans.

Numerous obstacles to treating breast cancer in Australia across different therapy techniques exist. Accessibility and prompt intervention are still major obstacles, starting with surgery, a crucial component of breast cancer treatment. The lack of specialized cancer centers in many rural and isolated places causes delays in diagnosis and treatment. Furthermore, long wait times for surgeries, especially in major cities, can be harmful to patients' health and outcomes due to high demand and little resources. An essential surgical treatment, radiotherapy, is not equally available throughout the nation. Patients in rural and isolated places may have trouble receiving radiation services, which could cause their treatment plans to change. Patients and their families face physical and psychological hardships as a result of the stress of long commutes to treatment facilities. Chemotherapy is an important component for the cancer treatment, though it has its own challenges it can be successful at killing cancer cells, but it certainly presents with unpleasant side effects like nausea and exhaustion. A never-ending problem is achieving therapy efficacy while reducing side effects. Potential strategies to decrease needless chemotherapy in patients who might not benefit from it include personalized medicine and focused medicines. While immunotherapy shows promise in treating a variety of malignancies, treating breast cancer specifically presents difficulties. Attention must be paid to identifying individuals who will respond well to these medicines and managing immune-related side effects, and high treatment costs. More research and clinical studies are required to discover the most effective approach for incorporating immunotherapy into typical breast cancer treatment procedures. Cancer treatment has been transformed by targeted therapy, yet there are still issues with drug accessibility. Affordable targeted treatments may be difficult for patients from lower socioeconomic backgrounds to afford, necessitating efforts to provide equal access. For all breast cancer patients to have better outcomes, it is crucial to work to close this disparity. An important part of this is the integration of palliative care, a crucial component of advanced breast cancer treatment, which is difficult. Palliative care must be incorporated into cancer therapy at an early stage, but patients and medical professionals may view this as "giving up" on curative treatment. The relevance of palliative care in enhancing a patient's quality of life throughout the later stages of breast cancer can be better understood by patients and their families through education and awareness-raising. [9,10,11]

Guidelines of breast cancer screening in Australia

Encouraging regular breast self-examination, clinical breast exams, and mammography screening can facilitate early detection and improve treatment outcomes. Moreover, collaboration between healthcare professionals, researchers, policymakers, and advocacy groups is essential to implement evidence-based strategies for breast cancer prevention, risk reduction, and early detection. By addressing the various risk factors associated with breast cancer, Australia can make significant strides in reducing the burden of this disease and improving the overall health and well-being of its population. [12,13]

Health Care services and programs

The results of breast cancer are also significantly influenced by health inequality. The results of poorer screening rates and delayed diagnoses occur in certain demographic groups, such as women from poorer socioeconomic origins or communities with diverse cultures and languages. In order to enable all women to engage in breast cancer screening and early detection campaigns, addressing these inequities calls for specialized outreach programs, culturally sensitive education, and information written in a language they can understand. Indigenous breast cancer health inequalities are a serious issue. Indigenous women have lower survival rates than non-Indigenous women because they are more likely to have a late diagnosis of breast cancer. Indigenous communities and health institutions must collaborate to create programs that are sensitive to cultural differences and remove obstacles to screening, diagnosis, and treatment. Reducing breast cancer inequalities in this community depends on educating and empowering Indigenous women to take charge of their health. Breast cancer patients and their families may feel insurmountable financial pressure. Australia has a publicly funded healthcare system, although some cancer treatments, drugs, and supportive care services might not be entirely covered, resulting in high out-of-pocket costs. These financial difficulties may have an impact on treatment choices and cause emotional discomfort. The stress can be lessened and patients' general wellbeing can be improved by enhancing the accessibility of financial support programs and making cancer treatment more affordable. It is important to not undervalue breast cancer's psychosocial effects. Anxiety, despair, and social isolation can occur after receiving a breast cancer diagnosis. Comprehensive breast cancer care must include emotional support and mental health services. The quality of life and overall well-being of breast cancer patients and survivors can be improved by implementing specialized psychosocial support programs that cater to their particular needs throughout the cancer journey. Another issue that needs consideration is breast cancer survivorship. It is essential to provide appropriate long-term follow-up treatment and survivorship programs as the number of breast cancer survivors rises. These programs ought to concentrate on addressing the medical, emotional, and social difficulties that survivors confront, including potential treatment side effects, recurrence fear, and reintegration into daily life. The goal of ongoing research is to develop individualized medicines, identify genetic risk factors, and unearth novel therapeutic choices. Translation of scientific findings into clinical practice depends critically on partnerships between research organizations, healthcare organizations, and pharmaceutical corporations. Additionally, cutting-edge technologies are on the horizon, presenting excellent prospects for early detection and focused treatment. Examples include precision medicine and liquid biopsies.

Additionally, breast cancer immunotherapy and targeted therapy have made significant strides in cancer research. Checkpoint inhibitors and CAR-T cell therapy are two immunotherapeutic that have demonstrated substantial promise for improving the immune system's capacity to identify and destroy cancer cells. HER2-targeted medicines and hormones are examples of targeted therapy. Including programs that use advanced technology to progress in the way that treatment and therapy are done will make it more efficient. [14,15,16,17]

Research organizations in Australia

In Australia, breast cancer research has been significantly advanced by various organizations and initiatives dedicated to combating this prevalent disease. Notably, the National Breast Cancer Foundation (NBCF) has played a pivotal role since its establishment in 1994. The NBCF has been at the forefront of funding groundbreaking research projects aimed at improving breast cancer prevention, early detection, and treatment. Their strategic investments have fostered a thriving research community in the country, allowing for collaborative efforts that accelerate progress in understanding breast cancer biology and developing novel therapeutic approaches. Additionally, the Breast Cancer Trials (BCT) organization has been instrumental in conducting large-scale clinical trials to evaluate the efficacy and safety of new treatments. Their efforts ensure that the latest discoveries are translated into clinical practice, offering breast cancer patients access to cutting-edge therapies that have undergone rigorous testing. Clinical trials play a crucial role in advancing breast cancer research and treatment options in Australia. These trials are designed to assess the efficacy and safety of new interventions, including drugs, targeted therapies, and innovative treatment approaches. Through the collaboration of research centers, hospitals, and academic institutions, Australian clinical trials provide valuable data that informs evidence-based medical decisions. They not only offer patients access to more advanced treatments but also contribute to the development of improved standards of care. Furthermore, translational research bridges the gap between basic scientific discoveries and their application in clinical settings. By integrating findings from laboratory research into clinical practice, translational research has led to a better understanding of the molecular basis of breast cancer and the development of personalized treatment strategies. Precision medicine has revolutionized breast cancer treatment in Australia by tailoring therapies to individual patients based on their unique genetic makeup, lifestyle, and environmental factors. This approach allows healthcare professionals to identify the most effective treatments while minimizing potential side effects, leading to better treatment outcomes and improved patient experiences. The implementation of precision medicine in breast cancer has led to the development of targeted therapies that specifically address the genetic mutations and alterations responsible for driving tumor growth. By understanding the molecular characteristics of each patient's cancer, clinicians can select treatments that are more likely to be effective, offering a higher chance of successful outcomes. The landscape of breast cancer treatment in Australia is continuously evolving with the introduction of emerging therapies and technologies. Immunotherapy, for instance, has shown promising results in certain breast cancer subtypes, harnessing the body's immune system to target and destroy cancer cells. Additionally, advancements in targeted therapies, such as PARP inhibitors for BRCA-mutated breast cancer, have provided new options for patients with specific genetic profiles. Nanotechnology and drug delivery systems are also being explored to enhance the efficacy and reduce the toxicity of chemotherapy. These innovative approaches are expanding treatment options and offering hope to patients with challenging cases of breast cancer. Genomic profiling has emerged as a powerful tool in understanding the genetic landscape of breast cancer tumors. By analyzing the DNA and molecular characteristics of cancer cells, researchers can identify specific mutations and alterations that drive tumor growth. This information is vital in guiding treatment decisions and selecting the most appropriate therapies for each patient. Genomic profiling has significantly contributed to the advancement of personalized medicine, allowing for tailored treatment regimens that take into account the unique genomic makeup of an individual's cancer. In Australia, initiatives focusing on genomic profiling have played a key role in increasing the precision of breast cancer treatments, resulting in improved patient outcomes and overall survival rates. [18,19,20,21]

Summary of Findings and Recommendations for Future Action

Breast Cancer has been an ongoing health concern in Australia more specifically Metastatic Breast Cancer which concerns the growth of Cancer cells from beyond just the breasts, but rapidly throughout the body such as the lungs, bones, liver, brain etc. Research Statistics in Australia have shown that an estimated 9,000-12,000 cases of individuals with metastatic cancer occur, of which about 3,000 people die every year. Even with the highest possible technological advances, it is difficult to treat patients with metastatic Breast Cancer. The treatment options are a line of treatments that move from one to another to build resistance and kill the cancer cells but this only lasts until all treatment options become exhausted. What's even more difficult is the fact that there are various cases including the subtypes of cancer and sometimes unfamiliar characteristics which make it an even more challenging task for doctors to find ways of treatments, to further add to the difficulties the patients need emotional and physical care. These problems as a rising concern in even developed places like Australia. Studies reveal that due to the need of when an individual is going through treatment a Metastatic Breast cancer nurse can be important to a patient. Resent research in 2023 in regard to safer treatments for Breast cancer include phytochemicals and nanocarriers which have been proven to be safer due to their biocompatible nature and efficient as well. This has led them to be an alternative form of therapy for chemotherapeutics in order to treat Breast Cancer. In anticancer activity of phytochemicals there are several diverse mechanisms which are implicated, as phytochemicals target the cancer cells. Phytochemicals are drugs extracted from medicinal plants and can be used for effective treatment, being organic substances, phytochemicals can be helpful tolerated by normal cells even when targeting cancer cells. Unfortunately, due to the ineffective treatments of herbal medicines it has become harder to provide the medications everywhere. (take Reference from above) In Australia the common treatments for Breast cancer include chemotherapy, target cell therapies etc. If the natural and more organic medications are used in treatment, they can be far more effective. In another research in 2023 which concerned synthesis and characterization of fluorescent Novel Pt(II) Cyclometallated complexes with Anticancer Activity revels from an experiment with cytotoxicity against a diverse panel of cell lines which included non-cancer cell line MCF10A and MCF-7, through the experiments findings the scientists learned that though complex they are selective to the cancer cells or in this case the cancer line. This could potentially mean that there are newer research avenues for anticancer agents. For Australia this could mean that the newer findings of ways of treatment, if its breast cancer nurses, phytochemicals and nanocarriers, and various anticancer treatments can account for other forms of treatments offered. [22,23,24,25]

Conclusion

The rise of diagnoses in Breast Cancer in Australians has raised several concerns over the course of several years. The current actions that are being taken towards the treatment of Breast cancer in Australia includes Awareness campaigns, chemotherapy, communities for help etc. The root causes however are often missed as the cases continue to rise at a steady rate. Through various different research papers, we find that use of carcinogens, unhealthy diets, and lack of exercise etc. are some risk factors because of which there are individuals being diagnosed with Breast Cancer. Therefore, breast screening and elimination has been promoted extensively but it is important that medical facilities provide care in larger developed areas and parts of rural Australia. It is important that the Breast Cancer treatment and therapy plans are effectively doing research and finding better forms of treatments such as the newer studies which are to be implicated including, phytochemicals and nanocarriers, anti-cancer agents and even appointing nurses/ oncologists to patients to help with both physical and mental health care needs, the upcoming discoveries can significantly impact the treatments and lead to newer findings through research on Breast Cancer treatments in Australia, and therefore helping the overall population of Australia to become more educated in terms of treatment plans.

Antarctica

Breast Cancer Findings in Antarctica

Since Antarctica does not have a fixed population and people usually stay only for 3-6 months, there are not many confirmed cases of breast cancer. However, Jerri Nielsen is the sole case of breast cancer recorded in 1998. Nielsen had been travelling on a one-year contract to the Amundsen-Scott station to serve as the medical doctor in that facility. But later on Nielsen had found that she was growing a lump in her breast and after she consulted other US physicians through e-mails and video conferences, she discovered she had developed breast cancer. While still in Antarctica, Nielsen had to operate on herself and extracted tissue samples for analysis. Soon thereafter, a military plane which was supposed to arrive during the spring came several weeks later to bring her back to the United States as soon as possible. After Nielsen had returned back to the US, she underwent multiple surgeries, complications, and a mastectomy causing her to go into a period of remission. But after being in remission for close to 7 years, in 2005 the cancer returned and metastasized into her brain, liver, and bones. During October of 2008, Dr. Nielsen had accounted that her cancer had now returned into a brain tumor and she then later passed away in June 23, 2009. [26]

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BCHDev DevelopOctober 13, 2023