Kate Browne discovered she had breast cancer by accident.
"I feel really fortunate because my breast cancer was picked up by another scan," she told SBS News. "In other words, it was picked up by accident."
Browne was found to have stage three breast cancer, requiring surgery and radiation. In her forties when she was diagnosed, she recalls having a conversation with her GP two years earlier about whether she needed screening scans.
But she was under the age of 50, had no family history of breast cancer, and had no symptoms. In other words, she wasn't a candidate to have a breast cancer scan.
She wonders 'what if' all the time.
"The 'what ifs' are huge — what would have happened if it hadn't been picked up in error?"
Kate Browne constantly wonders about what would have happened to her if she hadn't accidentally discovered she had stage three breast cancer. Source: SBS News / Supplied
Australian breast cancer rates among the highest in the world
A new study has found Australia has one of the largest rates of breast cancer diagnoses in the world.
The study by The University of Sydney, The University of Queensland, and Alberta Health Services in Canada studied global breast cancer data in 185 countries, assessing incidence rates and mortality rates.
According to the new research, one in 20 women globally are diagnosed with breast cancer, and a projected one in 70 are likely to die from the disease in their lifetime.
While the study found Australians were more likely to be diagnosed with breast cancer, it also found we're some of the least likely to die from it, with our mortality rates on the lower end of the spectrum.
Additionally, breast cancer mortality rates had reduced by 2.1 per cent per year, well on the way towards meeting the World Health Organization's (WHO) Global Breast Cancer Initiative goal of 2.5 per cent a year.
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Only seven countries — Malta, Denmark, Belgium, Switzerland, Lithuania, Netherlands and Slovenia — were on track to meeting WHO's goal, though mortality rates had decreased across 30 other countries as well.
The study found those from countries with Human Development Index (HDI) scores — used to measure a country's quality of life with factors like life expectancy, education and standard of living — were more likely to have higher mortality rates, with Fiji and Africa scoring the highest.
Meanwhile, countries with high HDI scores, like Australia, were more likely to have higher diagnosis rates.
Why Are Australia's breast cancer rates so high?
Nehmat Houssami, professor of public health at The University of Sydney and co-author of the study, said there are several reasons why Australia is at the top of the list but emphasised we shouldn't necessarily be alarmed.
"We have had high incidence rates for quite a long time," she told SBS News. "In more developed and affluent countries, we see high incidence rates."
She said this is partly due to the population structure of Australia.
"We have an ageing population. Age is one of the biggest risk factors for breast cancer … that in itself means that our incidence rates will be high."
But she said affluent countries like Australia are also hotspots for the risk factors of breast cancer associated with "contemporary lifestyles", like alcohol consumption and low physical activity.
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Adrian Esterman, professor of biostatistics and epidemiology at the University of South Australia, said the incidence number may also be inflated because of Australia's quality breast cancer screening programs.
"We have one of the best screening programs in the world," he told SBS News. "Not only do they pick up nasty breast cancers, they pick up lots of small tumours — tumours that might never have progressed to malignant disease."
He said having a higher incidence rate is a better outcome when it comes to mortality rates.
"The earlier you can detect a cancer, the better the outcome," he said.
"We have one of the highest incidence rates in the world, but also because of that screening program, we have one of the best survival rates in the world. So it's a two-edged sword.
"The silver lining is that if women do have the misfortune to get diagnosed with breast cancer, their survival is often extremely good.
"We have really, really good treatments these days. They're getting better all the time."
The 'chilling' diagnosis gap
While the numbers suggest Australia is on top of diagnosis, Browne is concerned about gaps in the system.
On top of her accidental diagnosis, she knows of a friend whose mammogram failed to detect a tumour. Another friend was turned away from a GP with an unusual skin condition on her breast that turned out to be breast cancer.
"It's a bit chilling when you look at the gap," she said.
BreastScreen Australia does not routinely track or report breast density as part of its screening process, which is something that Browne is concerned about.
"For women with very dense breasts like myself, a tumour may not even be picked up by a mammogram — they need an ultrasound," she said.
Browne believes there's "no harm" in giving women scans.
"There's no harm in encouraging women to come forward," she said.
"For me, the line around checking for lumps, while that's really critical, it's not always an indicator of breast cancer."
In Australia, the recommended breast cancer screening guidelines are for women aged 50 to 74 to get a mammogram every two years. Women aged 40 to 49 and those aged over 74 are also eligible to receive a free mammogram but don't receive an automatic invitation.
Houssami said the age bracket being actively invited to screenings is under review but added that breast cancer is uncommon for people under 40.
"It's not so common except for women who might be a genetically high risk. I think that women who are worried about their risk, particularly women who have a family history that might suggest a genetic risk, should ask their doctors to refer them," she said.
Houssami said Australia is "really fortunate" to have access to high-quality breast cancer diagnosis and treatment but emphasised the need for more research into preventative measures.
Need for post-treatment support
Now in remission for five years, Browne said more holistic support needs to be given to people with breast cancer after they finish treatment.
In her role as head of research and media at financial comparison service Compare Club, she conducted a survey with 400 women with breast cancer to understand the effects after treatment.
"During treatment, things were fairly logical. It wasn't fun, but it was logical. But it was the aftermath where you really feel like you're left on your own," Browne explained of her own experiences.
Now five years in remission, Kate Browne is calling for greater support for breast cancer victims after treatment ends. Source: SBS News / Supplied
"Some of the most powerful issues for women and for women and unexpected costs was around the lack of mental health support," Browne said.
"Another one was the loss of income, and what really broke my heart is so many women said they just quietly quit their jobs. They'd lost their confidence. They didn't have any energy."
Another side effect of breast cancer for Browne was divorce.
At least 12.35 per cent of women surveyed also experienced divorce or separation as a result of their diagnosis.
"These women walked a really similar path to myself. I went from being happily married and fairly financially secure to very much not," Browne said.
"While the results were pretty confronting, it was very affirming to me that this is a very common issue — but one that's not really being addressed, unfortunately."
She hopes early detection will help other women avoid the same fate she endured.
"If I could wish for one thing around breast cancer screening and diagnosis, it's that more women go and get scanned more early. We're seeing plenty of women with no family history or even symptoms like me being diagnosed with breast cancer, and early detection is critical."
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