News

---

Latest GP guidance for breast cancer prevention

---

In Australia, one in seven women will be diagnosed with breast cancer in their lifetime, making it the most common cancer to be diagnosed in women – and the second leading cause of cancer death.
 
To ensure GPs are across the most up to date guidance, breast health is the focus of the latest issue of the RACGP’s Australian Journal of General Practice (AJGP).
 
Among the inclusions is a comprehensive article written by Dr Sandy Minck, a GP and member of BreastScreen Queensland’s Clinical Standards and Excellence Committee, about breast cancer screening and evidence-based strategies for prevention.
 
It outlines breast cancer risk factors, personalised risk assessment tools, and the role of lifestyle modification, risk-reducing medication and surgery.
 
In Australia, the incidence of breast cancer is rising, especially among younger women. But to see this number drop, Dr Minck told newsGP that the conversation needs to shift from early detection to include risk reduction strategies – and it needs to start at a much younger age.
 
‘We know that screening and early detection reduces deaths from breast cancer, but women and men are still having significant side effects and long-term impacts from breast cancer treatments. This gets talked about less often,’ she said.
 
‘More than 75% of cases occur in patients over 50, but there has been a 10% increase among patients under 50 in the last 20 years, so breast cancer will be a concern for younger patients too.
 
‘Many international organisations are suggesting that breast cancer risk assessments should start at age 25.’
 
In Australia, risk assessments for breast cancer generally start when women reach their 40s, with the national BreastScreen Australia program targeting women aged 50–74 for routine screening.
 
However, statistics show that around 1000 women aged under 40 are diagnosed with breast cancer in Australia each year, equivalent to about three young women each day.
 
Dr Minck says this concerning rise is thought to be due to multiple factors, including genetic, environmental, lifestyle, and changing reproductive factors such as having children later or not at all.
 
‘There is a similar rise in colon and other cancers in people under 50, so being aware of this, and addressing lifestyle risk factors at a young age is becoming increasingly important,’ she said.
 
These lifestyle factors include:

• maintaining a healthy weight
• avoiding or limiting alcohol
• getting regular exercise. 

There is also medication available, which Dr Minck says can decrease breast cancer risk by 30–60%, however awareness and knowledge of this remains low amongst many healthcare professionals.
 
‘There are two main categories of medication, selective estrogen receptor modulators and aromatase inhibitors,’ she said.
 
‘These are an effective risk-reducing strategy for patients who do not want to undergo, or want to postpone, a mastectomy.’
 
Meanwhile, for those at very high risk of developing breast cancer, risk-reducing surgery is an option.
 
Having undergone a risk-reducing mastectomy in 2023 herself, Dr Minck acknowledges this can be an overwhelming decision for patients, particularly for younger women who may want to start or continue a family – not to mention the multiple reconstruction options to consider.
 
‘The advantage, if you can call it that, in the risk reducing space is that women do generally have more time to make decisions,’ she said.  
 
‘These women are best referred to a high-risk clinic to discuss all the options. However, GPs can help prepare women for these consultations by providing information, resources, support and talk through any concerns or specific challenges.
 
‘To do this, GPs could familiarise themselves with resources available to recommend and share.’
 
The latest issue of AJGP also includes an article with the most recent updates on the early detection of breast cancer informed by the 10th edition of the RACGP’s Red Book preventive health guidelines.
 
Dr Minck says the first step to reducing the risk of breast cancer and to early detection is raising awareness, and GPs are uniquely placed to do this.
 
‘Any consultation, but especially those relating to women’s health, is an opportunity to start conversations about breast health,’ she said.
 
‘Many women and men are unaware of their risk and the impact of lifestyle factors on risk.
 
‘The more conversations that are started, the more people will be empowered to start thinking about lifestyle changes and what they can do to understand and act on their risk.’
 
As a first step, Dr Minck said GPs can recommend patients complete a risk assessment, such as iPrevent.
 
‘This will give a 10 year and lifetime breast cancer risk estimate and include information on lifestyle factors and, if relevant, medication and surgical options,’ she said.
 
‘Risk assessments need to be repeated, as age is one of the most significant risk factors, and family history, reproductive, hormonal and lifestyle factors also change over time.’
 
Meanwhile, for GPs wanting to build their knowledge and confidence in this space, the Queensland-based GP recommends familiarising themselves with the resources in her AJGP article as a start.
 
‘I would also recommend joining the RACGP Breast Medicine Specific Interests group where they are members with expertise who are happy to share information and resources,’ Dr Minck said.
 
The breast health issue of AJGP also features articles on assessing and managing breast skin changes; assessing premature breast development; and a clinical challenge on breast health topics which allows GPs to complete five hours of RACGP-approved continuing professional development.
 
Log in below to join the conversation.

---

breast cancer GP research prevention screening

---