Kate Browne discovered she had breast cancer by accident.
"I feel really fortunate because my breast cancer was picked up by another scan. In other words, it was picked up by accident. I was under the age of 50 when I was diagnosed. I had no family history and no symptoms. So it was very fortunate it was picked up because it was stage three and it required surgery and radiation."
In her 40s when she was diagnosed, Ms Browne recalls having a conversation with her G-P two years earlier about whether she needed screening scans.
But at that time, she wasn't a candidate.
It's left her wondering 'what if'.
"The what ifs are huge and probably for me, the what if is, what would have happened if it hadn't been picked up in error? I mean, the chances of me having a scan across my chest were so low. And for that to be picked up. It's very easy to hear people say, check your boobs, check for a lump. I actually had a 4.5 centimetre tumour when I was diagnosed that was not palpable either by myself or my surgeon."
A new study by the University of Sydney, the University of Queensland, and Alberta Health Services in Canada has found one in 20 women globally is diagnosed with breast cancer.
A projected one in 70 is likely to die from the disease in their lifetime.
Of data recorded in 185 countries, Australia was found to have one of the highest rates of diagnosis.
Nehmat Houssami, Professor of Public Health at the University of Sydney and co-author of the study, says there are several reasons why Australia is at the top of the list.
"For Australia it's partly the population structure. So, we have an ageing population, so age is one of the biggest risk factors for breast cancer. And the biggest burden in breast cancer is in women 50 and older. So that in itself means that our incidence rates will be high. But the other factor contributing to the high incidence rates is what I refer to as the population risk profile."
Those risks, Dr Houssami says, are associated with a contemporary lifestyle in affluent countries – including alcohol consumption and low physical activity.
But she emphasises we shouldn't be alarmed.
"We have a reduced mortality from breast cancer in Australia. So we have to look at that positive outcome. A reduction in mortality rates is something that has occurred in Australia over several decades, including over the last 10 years."
Professor Adrian Esterman, Chair of Biostatistics and Epidemiology at the University of South Australia, says the number may also be inflated because of Australia's breast cancer screening programs.
"We have one of the best screening programs in the world, and the screening programs pick up breast cancers. Not only do they pick up nasty breast cancers, they pick up lots of small tumours, tumours that might never progress to malignant disease. And so for that reason, we have one of the highest instance 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."
He also says having a higher incidence rate helps reduce mortality rates.
"The earlier you can detect a cancer, the better the outcome. And that is because cancers which are detected when they're very small can easily simply be surgically removed and the woman is no longer at risk. And that's obviously the ideal situation. But as soon as the cancer starts growing larger and then unfortunately eventually metastasises - starts moving into other parts of the body - then you have a much higher mortality rate."
While the numbers suggest Australia is on top of diagnosis, Ms Browne remains concerned about gaps in the system.
In addition to her accidental diagnosis, she's seen one friend have a mammogram that didn't pick up 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.
"Now that's just in my own circle. So, I do think we need to be a little bit clearer around this. I think there's no harm in giving women scans. There's no harm in encouraging women to come forward. And for me, the line around checking for lumps, well that's really critical. It's not always an indication of breast cancer."
BreastScreen Australia does not routinely track or report breast density as part of its screening process, something Kate Browne says she's concerned about.
"For women with very dense breasts, for example, a tumour may not even be picked up by a mammogram - they also need an ultrasound. Now, scans are available for women over 40, but it doesn't feel like it's necessarily recommended unless you do have that history. And I think there's a lot of confusion in that space."
In Australia, the recommended breast cancer screening guidelines say women aged 50 to 74 should 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 invitation.
Dr Houssami says those age brackets are currently under review.
"Before age 40, breast cancer is actually not so common except for women who might be at genetically high risk. So, I think that women who are worried about their risk when particularly women who have a family history that might suggest a genetic risk, should ask their family doctors to refer them to genetic clinic to have a risk assessment."
Now in remission for five years, Ms Browne says 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 Compare Club, she's conducted a survey with 400 women with breast cancer to understand the effects after treatment.
"It's very business-like. You move from place to place as they deal with each problem. And it would be great to see a bit more holistic care around that so women don't feel blindsided because that's what we're hearing and that's certainly how I felt during the 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 quite left on your own."
