Breast cancer immunization: approaches and efficacy

Breast Cancer Immunization

The need for increased breast cancer screening: New Zealand

The incidence of breast cancer in New Zealand is comparable to that of the rest of the developed world. After skin cancer, it is the most commonly-diagnosed and most common cause of death of women from cancer (Cunningham, Shaw & Sarfati 2010:2). In general, white, highly-educated women have a higher instance of breast cancer, and cancer risk increases with age. "Older age at first birth, lower parity, lack of breast feeding, younger age at menarche, older age at menopause and use of menopausal hormone therapy (HT) are all related to increases in breast cancer risk" (Cunningham, Shaw & Sarfati 2010:2).

The need for early detection is widely acknowledged, but screening programs have come under increased scrutiny because of their high rates of false positives. A recent study found that while "43 deaths from breast cancer prevented for every 10-000 women invited for screening. The downside was an estimated 19% rate of over-diagnosis: 129 of the 681 cancers detected in those 10, 000 women would not have caused symptoms or death during the patient's lifetime" thus subjecting women to needless surgery and psychological stress (Godlee 2013). However, reduced screening runs the risk of missing breast cancer amongst demographics of women who are not historically screened for breast cancer. Recent data suggests that rapidly-spreading cancer is increasing amongst women under the age of 39 and is particularly deadly for this group because it is so rapidly-spreading. "While the five-year survival rate for breast cancer that has not spread is 93%, for women 39 and under whose cancer has spread, it's only 31%" (Fox 2013). The rise in young victims has been attributed to late childbirth and other, as-yet undetected environmental factors.

There is a known genetic link between breast cancer and two specific genes, namely, BRCA1 and BRCA2, and currently screening is recommended for patients with a long history of breast cancer within their immediate families (Genetic testing, 2013, The Breast Centre). Mastectomy and reconstructive surgery is usually recommended in such instances, given that this can reduce the risk of contracting breast cancer 90%. However, only a very small number of breast cancer cases (5%) can be attributed to these genes and there are likely other genetic factors which have a strong role in the development of the disorder (Genetic testing, 2013, The Breast Centre). Even for those without these genes, there is a strong genetic component in the likelihood of developing of breast cancer. For example, "rates of breast cancer amongst Asian women were consistently lower than those of European and M-ori women," even when controlling for other known risk factors such as not having children or cigarette smoking (Cunningham, Shaw & Sarfati 2010:10).