30,000 voices: Informing a better future for breast cancer in Aotearoa New Zealand

     No other cancer has had the impact on New Zealand women that breast cancer has. And nowhere is the scale of that impact better seen than in the story of 30,000 women over 20 years: Te Rēhita Mate Ūtaetae - Breast Cancer Foundation National Register.

     This report of the Register data reveals great progress over the years. Breast cancer survival has improved hugely; it is heartening and inspiring to see the significant, often remarkable, gains made across all ethnicities, ages and regions.

     The survival gap between wāhine Māori, Pacific and European women has narrowed and in some cases all but disappeared. Our five-year survival appears to be as good as the countries we like to compare against, no doubt thanks to excellent participation in BreastScreen Aotearoa finding cancers earlier, and better treatments lowering the risk of recurrence. New Zealand clinical practice aligns well with Australasian surgical benchmarks.

     And although we have successes to celebrate, we also have the “stubborn stains” that leave us nowhere near a clean sweep. Take a look at our 10-year survival statistics and it becomes obvious where we need to do better. For younger women. For women who struggle to access screening, particularly wāhine Māori. For Pacific women. For women with higher grade or later stage cancer. For women with triple negative breast cancer. Too many of these women have their breast cancer come back after more than five years, and too many women are diagnosed at a young age for us to be satisfied with five years of life after cancer.

     This report is a start, highlighting areas where survival gains are lagging. It reveals where current practice may be out of step with guidelines – for example, the ratio of breast-conserving surgery to mastectomy. And it identifies where resource constraints could cause life-threatening delays. We look forward to working with Government, Te Aho o Te Kahu the Cancer Control Agency, BreastScreen Aotearoa, clinicians and patients to investigate and address these challenges. As we work through these challenges, let us remember that our purpose is not merely changing numbers or improving systems. He aha te mea nui o te ao? He tangata, he tangata, he tangata. What is the most important thing in the world? It is the people, it is the people, it is the people.