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Extra info for Management of Early Breast Cancer

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The major sections within each chapter reflect specific clinical questions (see Chapter 11, General section: methods). Each section includes a summary of the evidence identified that met inclusion criteria and a summary of the findings, and concludes with the recommendations and good practice points developed. Breast cancer epidemiology Breast cancer is a significant health issue for New Zealanders and is the leading cause of cancer mortality in New Zealand women. 4% of all female registrations), with an age-standardised rate of 92 cases per 100,000 females.

Between December 1998 and June 2004, the New Zealand breast cancer screening programme – BreastScreen Aotearoa – offered publicly funded mammography to all New Zealand women without symptoms of breast disease aged 50 to 64 years, with the aim of reducing mortality from breast cancer. From 1 July 2004, women aged 45 to 49 years and 65 to 69 years also became eligible for publicly funded mammography. One of the essential requirements of an effective screening programme is that women who have cancers detected subsequently receive optimal treatment.

56 Development of recommendations Based on the expert opinion of the GDT and the representatives of the appropriate ethnic groups the following good practice points were developed. 18 Management of early breast cancer Chapter 2: General principles of care Good practice points Data including the ethnicity of patients with early breast cancer should be recorded in a national database  Health practitioners and others providing cancer care should receive training and support in culturally competent, patient-centred care  Workforce development should target the training of more Mäori and Pacific care providers including breast care nurses and coordinators of care  Mäori- and Pacific-specific cancer services or service components should be delivered by existing Mäori or Pacific providers or in partnership with Mäori or Pacific providers  An invitation for women to bring whänau/family/support should be included with clinic appointment information  Adequate time should be allocated to provide culturally appropriate care and to meet the needs of the woman with early breast cancer in an appropriate environment  Practitioners should be aware of culturally sensitive issues such as exposure of the body  Practitioners should consult with Mäori and Pacific women with early breast cancer about preferences for care, including final disposal of tissue or body parts surgically removed  To ensure effective communication for Pacific peoples and others whose first language is not English, competent interpreters and/or coordinators of care should be provided  Acknowledgement and respect for a woman’s beliefs regarding traditional health care practices are important Consideration should be given to allocating additional time for cross-cultural consultation, especially for those consultations requiring an interpreter  Opinion of the Guideline Development Team, or feedback from consultation within New Zealand where no evidence is available Management of early breast cancer 19 3 Staging This chapter outlines the evidence and recommendations in relation to staging in early breast cancer and includes: • routine staging investigations • preoperative magnetic resonance imaging (MRI).

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