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House of Assembly - Fifty-First Parliament, Second Session (51-2)
2007-10-25 Daily Xml
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BREASTSCREEN SA

The Hon. R.B. SUCH (Fisher) (11:48): I move:

That this house congratulates BreastScreen SA on its services to the women of South Australia since 1989 and urges women, especially in the target age group, to avail themselves of the mammogram services provided by BreastScreen.

I was not particularly aware at the time I moved this motion that it was breast cancer awareness week, but the timing was fortuitous. What prompted me to raise this was that a near relative recently was diagnosed with breast cancer as a result of having a mammogram carried out by BreastScreen SA. My close relative was called back because the initial screening showed that there could be something present in one of her breasts which needed further attention. She went to the Wayville clinic and they diagnosed one of the less serious breast cancers, the milk duct in situ breast cancer. You still do not want it but, if you are going to have breast cancer, I guess it is probably better to have that than some of the more aggressive and more serious alternatives. Anyway, the good news story is that, despite being diagnosed with that milk duct cancer, she was able to get surgery relatively promptly. She only had to have a small section of the breast taken out and, as far as we know now, it all looks good and clearly needs to be monitored into the future.

My relative, and other female members of my family, speak very highly of BreastScreen SA, and the way in which the staff conduct themselves. We know that not all women in the target group avail themselves of this mammogram service. I understand from women that the process can sometimes be a little bit uncomfortable but, as I said before in relation to prostate cancer, it is better than having the disease manifest itself and remain undetected. So, I want to pay tribute to BreastScreen SA, which has been operating since 1988 when there was a pilot screening project conducted here. It was the first to sign an agreement with the commonwealth to participate in the national program for the early detection of breast cancer, and it is now known as BreastScreen Australia.

The aim of BreastScreen SA is to reduce mortality and morbidity attributable to breast cancer by providing a free government screening mammography service on a state-wide basis. To that end, BreastScreen SA has six permanent clinics in Adelaide, and that is scheduled for now until 2009, and will run 34 mobile clinics in rural South Australia. Once again, it is very important that country people have access to the best screening and, subsequently, if necessary, the best treatment options and access to specialists and other medical professions.

BreastScreen SA's prime target is women aged 50 to 69 years, but women aged 40 years and over are eligible to attend. If there is a particular circumstance, a high risk or something like that, then it is possible for women to attend more frequently than the normal two year interval.

One of the reasons for raising this today is not only to congratulate BreastScreen and the staff who work there for their professionalism and their compassion but also to get the message out; that is, get checked out, have a mammogram. As BreastScreen points out in its literature, one mammogram is not enough to last a lifetime. Women should not put off having a screening mammogram. I have been disappointed to hear some women say, 'I will worry about cancer if I get it'. If you do that, you might be leaving things too late.

The diagnosis of breast cancer has improved through improved technology and screening techniques but, sadly, many women are still diagnosed too late. In that regard, I know a woman who visited the doctor and was told, 'Look, you have a muscle problem.' As it turned out, it was cancer and, sadly, I think they have now determined that it has spread. It is important that not only women have regular screenings if they are in the target age group but also that they are persistent and ensure that, whichever doctor they see, that doctor is vigilant and diligent in what they do and does not try to fob them off with a quick answer about a muscle problem or something of the like. You need to be your own best advocate.

I make the point that, when someone is diagnosed with breast cancer, as with any cancer, it is very important that the person is given strong support by family and other members. From talking to women who have recently been diagnosed, they say that, when they are talking to the doctor and the doctor is trying to explain some of the technical aspects, it tends to go straight over their head because they are in a state of shock and do not necessarily absorb what the doctor is saying in terms of aspects of having breast cancer.

The success of BreastScreen is measured in a whole lot of ways. I refer to work done by Dr David Roder, who is the son of the late judge Roder with whom many of you may have had dealings. His analysis of the effectiveness of BreastScreen shows that the death rate for screening in the target group 50 to 69 has fallen from 68 per 100,000 in 1993 (shortly after the screening started) to 57 per 100,000 in 2002. Hopefully, one would expect those figures to decline. Many women are still dying from breast cancer, so we want to reduce that. Obviously one would aim to reduce it to zero. Between 1 January 1989 and 31 December 2004, 219,000 women had been screened through BreastScreen; and between 1 January 1989 to 31 December 2003, that screening detected 4,081 cancers.

There is still a way to go because—and these are the latest figures—up until 31 December 2004, 63 per cent of women in the 50 to 69 target age bracket were screened, and that is far too low—63 per cent. Many women are still not availing themselves of the service, which is a free service. I emphasise that the people involved in running it are not only technically qualified but very compassionate, so there is no reason why any woman should feel deterred from accessing the wonderful services of BreastScreen SA.

I believe that this motion would receive the support of all members. There is a wonderful network of women and organisations promoting awareness of breast cancer, trying to get better treatment options and better ways of dealing with this insidious disease. It is a very significant disease and I can understand why it creates fear amongst women, because it strikes at the heart of the woman's femininity. I have had some women say to me that, if they were diagnosed, they would kill themselves. We do not want women doing that, but women need to realise that early detection and early treatment gives you a very good chance.

I commend BreastScreen to all South Australians and particularly to women for the wonderful job it has done and continues to do throughout this state. I commend the motion to the house.

Ms SIMMONS (Morialta) (11:59): I support this motion. I am very pleased to report that BreastScreen SA, the free statewide breast cancer screening program, is regarded as a leader in the field and in March this year was awarded full accreditation for four years by the national screening program BreastScreen Australia. The program aims to reduce morbidity and mortality from breast cancer (as the honourable member has advised) and adheres to the WHO principles of screening, which is regularly and strictly monitored to ensure that national standards are met. Adherence to these standards sends a very positive message to clients, who can expect an excellent level of service throughout the screening and assessment process. Screening refers to the use of simple tests across a healthy population in order to identify individuals who have a disease, but who do not yet have symptoms. Breast cancer is one of the most common causes of death from cancer in Australian women. One in 53 women will die from breast cancer. This means that, before the age of 75, a woman's chance of dying from breast cancer is about one in every 53 women.

At this point, I want to pay tribute to my close and dear friend, Rusty Palmer, who died earlier this year after a brave battle with breast cancer. In South Australia in 2002, 1,040 new cases of breast cancer were diagnosed in women. Interestingly, there were also seven cases in men. In the same year, 290 women and one man died from this disease. The BreastScreen SA program provides free screening mammograms (or breast X-rays) at two-yearly intervals, targeted at all women aged 50 to 69 without breast symptoms. It is estimated that this routine screening reduces the chance of dying from breast cancer by about 40 per cent.

Women aged 40 to 49 and over 70 are also very welcome to attend free screening sessions, although the benefit of screening mammograms has not been clearly established for women in this age group. Women over 40 with a strong family history of breast cancer are also encouraged to attend screening mammograms every year, not just every two years.

BreastScreen SA has six fixed clinics in the metropolitan area. They are located at Wayville, Marion, Twin Plaza in the city, Frome Road, Salisbury and Westfield Shopping Town at Arndale. It also has three mobile units, which visit 27 country regions and seven outer metropolitan areas every two years, which is the recommended screening interval. Since its inception, this amazing service has provided more than 950,000 free screening mammograms and, to the end of 2005, had detected a total of 4,857 breast cancers.

I encourage all women my age (over 50) to take advantage of this free service. Although not 100 per cent accurate, it is currently the most effective tool for early detection. Screening does not cure cancer or prevent breast cancer from developing in the future and, therefore, all women need to stay vigilant, self-examine and remain aware of any symptoms or abnormalities in their breasts and take action.

In conclusion, I would like to highlight recent reports of success enjoyed by BreastScreen SA in detecting breast cancer at an early stage, which increases the chances of survival, and offer them my congratulations. For example, in mid June 2007, the report 'Efficacy of population-based screening in Australia' indicated that women participating in mammogram screening at BreastScreen SA reduced their risk of dying from breast cancer by up to 41 per cent. I again urge all women in the target age group—50 to 69—to call BreastScreen SA on 13 20 50 for an appointment, and I encourage them to have a screening mammogram every two years. I commend the motion to the house.

Ms BREUER (Giles) (12:03): I want to talk on a more personal level about the impact of the breast screening van on women in South Australia. My family was personally touched by breast cancer six years ago: my sister-in-law was diagnosed with breast cancer and had treatment for about eight months in the form of chemotherapy and radiotherapy. I remember a most horrendous Christmas, when Sue had just come back from a chemotherapy treatment and, as is the case with many people after chemotherapy, was very sick for a few days. On Christmas Day she was extremely sick. She looked terrible: she had no hair or eyebrows and she had lost a considerable amount of weight. I am very pleased to say that Sue is certainly still with us. She is fighting fit and is able to enjoy the odd glass of champagne. She has moved on.

However, the impact of that episode of breast cancer on our lives as a family was quite incredible. I think we all sat back and thought about our lives and what was really important—and, of course, what is most important in people's lives is family and family relationships. So, it was a terrible time for all of us—and, of course, for Sue, in particular, who coped with most of it, and my brother, who was with her all the time during her treatment; they felt it more than any of us. However, all of us became very aware of the importance of our family life, and that has carried us through over the years with respect to a number of other crises—for instance, when we both lost parents. That strong family feeling was always there, and the strength of knowing that, out of some bad, some good can come. Sue was an example in our family, but many other families that of I know of have been touched by breast cancer and have had similar incidents and results in their families.

The breast screening van is a regular visitor to Whyalla. It visits every two years, and it parks itself right by my office and takes up the car space there. Every two years I hear a minor complaint, 'The breast cancer van is back again. Oh, damn.' However, I am always very pleased to see it there, because it is very visible in the main shopping centre in the city, and women and men who go past see it constantly. So, it is has a very visible impact on people in our community.

The van stays for two months, and hundreds of women have been screened. Plenty of warning is given when the van comes into town: anyone over the age of 50 is sent a letter and a follow-up. Many women in Whyalla have been screened and, as a result, many have had their lives saved by this. The van also travels to other country areas. Coober Pedy is visited regularly; after Whyalla, the van usually goes to Coober Pedy.

This is really good for country women, because having to travel to Adelaide to have any sort of screening or testing carried out is a real issue for women. It does not matter who you are: every time you go in for that breast screening, at the back of your mind you think, 'Gosh, I hope there's nothing wrong.' There is certainly a feeling of relief when you open that letter and are informed that you are okay. It has great results: you feel really good after that, because it does worry people. If women in country areas have to travel to the city and leave their family behind, it can be very difficult for them.

I congratulate the BreastScreen program; they do an excellent job. I want to comment about mammograms and let you know that I would probably rather have a baby than a mammogram. It is not a good experience for women to have a mammogram, particularly when you are well endowed like I am. I have often asked those at BreastScreen whether it is difficult for women who are big-breasted to have a mammogram and they have pointed out that it is not more difficult, it just takes more equipment. More photos have to be taken. It is akin to having your head put in a vice and screwed in for a while. It is not a pleasant experience.

However, it is not something you neglect because of that. I think we all realise the value of it and, after you have had your first one, it is not quite as bad because you know what to expect, and you just hold your breath. Mammograms are not a pleasant experience for women and I could probably give the example of something similar for men but I will not go into that. It is well worth having and it saves lives. Many women's lives have been saved by having mammograms.

I think the BreastScreen program is an excellent program and I support the motion. I think it is a good motion and we did a similar thing last year, but we need to keep bringing it to the fore, particularly to the attention of women in South Australia. I urge all the men in this place and out there to support their women in going for breast screening, particularly once women reach 50. I urge men to encourage their wives, partners, sisters and mothers to get tested because, if breast cancer is caught early, women can be saved. If it is left too late, it is very difficult.

One of the assumptions about breast cancer is that older women get it and I know that the BreastScreen program covers women over 50, but many younger women get breast cancer. In my family's case, my sister-in-law was only 42 when she developed breast cancer. We all know the tragic story of Belinda Emmett which I think broke many hearts. We have also followed with interest the progress of Glenn McGrath's wife, Jane. She has done a wonderful job in promoting breast screening to women and making women aware of breast cancer and supporting women. I know that my sister-in-law, Sue, and my brother, Gary, were very much supported by the literature that was put out by Glenn and Jane McGrath. When they were going through their treatment they read it and it supported them very well.

Breast cancer is a major health issue for women all over the world. In this state we are very lucky that we have a program such as BreastScreen. We are very lucky that the program is able to go out to country areas in order to work with women in screening them and saving many lives. So, I congratulate BreastScreen on its services to the women of South Australia.

Mr GRIFFITHS (Goyder) (12:11): I support the motion and I commend the member for Fisher for bringing this to the house. I also sincerely thank the member for Morialta for the details she provided in her contribution. Breast cancer has affected my family, as it has affected many in this place. The information that the member for Morialta provided indicated that one in 53 women face the possibility of having breast cancer, and that is terrible. Technology improves in so many ways in our lives, so let's hope that technology ensures that this terrible disease is removed as soon as possible.

In my case, my wife's sister was diagnosed with breast cancer at the age of 35. She was pregnant at the time with her third child when she was diagnosed in the last trimester. She and her family faced a very difficult decision about what to do. I am very thankful that they chose to delay treatment until a week after my nephew was born. My sister-in-law had a mastectomy within three days of giving birth. She has had ongoing treatment since then. It has come back once and she has had a second round of treatment. My wife told me only this week that the latest news is that she is okay again. So, we live in the hope that it will be permanently gone from my sister-in-law because she has a wonderful family. I know that the easy decision would have been to determine a different course of action when she was pregnant but she chose to have that wonderful young man, Arien. He is a beautiful young boy and I know that he will make a difference to the world. I think it is all part of the greater reason that God has for many of us.

One of the greatest pleasures I have had since becoming a member of parliament occurred earlier this year when I had the opportunity to open the Relay for Life on the southern Yorke Peninsula. Relay for Life is designed around bringing in some necessary funds to help with cancer research. I relayed to the people there that day the story of my sister-in-law and my wife, who was there holding the rope for the first people who had had cancer and recovered from it who had the honour of doing the first lap, was crying while I was speaking. The press representative there ran up to comfort her and she started to cry because her father had died from cancer and her mother was ill with it.

Cancer truly affects so many people. Breast screening is important. My wife is 43 and her other sister who has not had breast cancer is 42, and they have both received yearly screenings since their sister was first diagnosed. We talk about it wherever we go and the fact that families need to be aware of it. They need to ensure that self-examination occurs and that every opportunity is taken to ensure that you are checked out because you should not just assume that you are a healthy person. Human nature means that we think we are impervious to every disease and everything that can harm us. Blokes are even worse than ladies. If anything, I think this has prompted the thought that medical technology out there can help us be aware of issues in our own bodies. Let's make sure that we use it. I commend the member for Fisher for bringing the motion to the house. I thank the member for Morialta for the details in her speech. I am sure that all in this place will support the motion.

Dr McFETRIDGE (Morphett) (12:14): I also rise to support this motion. As the member for Goyder and others have said, many people in this place would know somebody who has been affected by breast cancer and, in many cases, who has died from it. I congratulate BreastScreen for the terrific work they do in assisting people at least to monitor their own health through radiography and mammography. Another way that women can be alerted to any changes in their bodies is through genetic testing. I have introduced legislation in this place on, I think, four occasions to ensure that the public have access to genetic testing. Unfortunately, one of the problems with modern research is that money is needed to continue that research, and people want a commercial return for it. A lot of genes have been isolated and then patented. The licences to use that genetic test for that gene is, in many cases, quite expensive.

I understand that the genes for breast cancer (the BRCA-1 and BRCA-2 gene) have been patented by an organisation. In some cases, the cost of having that test is $10,000. It should not be health care for the rich; it should be health care for everybody. So I urge governments of all persuasions (state and federal) to look at the issue of gene patenting, because we do not want to see people, particularly women, excluded because they cannot afford to have their health monitored and tested.

While the BreastScreen program is absolutely fantastic, the ability to go and have a blood test and have your DNA typed and check whether you have the BRCA-1 or BRCA-2 gene is absolutely vital. I know this because a very good friend of mine has the BRCA-1 BRCA-2 gene. She has a 90 per cent chance of dying by the age of 40 if she does not go through a number of major procedures. She has had a bilateral mastectomy, she is having an ovariohysterectomy soon, and she is faced with ongoing testing to ensure that she does not suffer from the cancers that are linked to the BRCA-1 BRCA-2 gene.

We know now that a number of genes are linked to various cancers. To see people excluded from having the knowledge that they could be susceptible to one of these diseases—whether it be breast cancer, bowel cancer, Parkinson's, or any number of diseases—because they cannot afford the test would be atrocious. I say to members that the gene patenting issue is one that we will have to face in the future: the cost of either paying the licence fees or, better still, outlawing the charges for these vital tests. The licensing of these vital tests is something we will have to work out.

On Monday, I had the pleasure of going to the launch of Hopes & Hurdles by the Breast Cancer Network Australia at the Stamford down at the bay. This is an organisation for survivors of breast cancer. These are women who have been through various surgeries and chemotherapies but are living with secondary cancers. I heard some harrowing stories related by some of the survivors of primary cancers who are having to live with secondary metastases. In fact, one lady had overcome the original onset of breast cancer to then find it had spread to her bones. She had treatment for that and, on Friday of last week, before she came to speak at the Breast Cancer Network, she was told she had a secondary cancer in her liver. So, she is going to have to go in again and face further chemotherapy. I encourage all women to visit the Breast Cancer Network Australia website and look at the Hopes & Hurdles program. It talks about all the forms of treatment and the social, financial and health issues associated with breast cancer.

I will finish by saying that a number of men suffer from breast cancer as well. Although I did not speak to the member for Fisher's previous motion, it is all part of men's health, too. I am off for my five yearly colonoscopy, or 'bumcam' as my kids call it, in a month's time, because I am aware that I am not immortal, unfortunately. I want to take care of my own health. The member for Mount Gambier's recent episode is a salient example to us all that we are mortal and we should look after our health. If he had not been so fit, he may not still be with us, which would have been a disappointment—and I say that most sincerely. I will finish by saying that I support the motion with the utmost sincerity, and I urge all women to be tested. You may not be the one who is able to overcome a late-stage onset diagnosis. Get the test and make sure you get treatment early.

The Hon. R.B. SUCH (Fisher) (12:20): I thank members for their support. I just say, as I said earlier, at the moment only around 63 per cent of women are being regularly screened, women in the target age group of 50 to 69. That needs to be significantly increased, and I would urge all members here to use their newsletters and so on to prompt their constituents to undertake the appropriate screening, and likewise use their newsletters to encourage men to be checked out for their various health issues.

The member for Giles mentioned about the unpleasant experience of having a mammogram, and members can visualise what it is like to be squeezed in a machine. There are some new techniques and some new machines coming on to the market, and I know someone who recently had one, not through BreastScreen, because they had already been to BreastScreen but they wanted an additional assessment and they said that the equipment used by the private facility was less painful. But, as I said earlier on, it is better to have a bit of discomfort than get a sentence of death which is what people are confronted with if they play Russian roulette with their health. So I commend the motion to the house and I trust that all members will support it.

Motion carried.

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