Objective: Breast cancer accounts for 28% of all new cancers in Australian Women¹. Patients  in regional areas historically  have poorer outcomes compared to their metropolitan counterparts. We conducted a clinical audit on breast cancer patients treated  at Goulburn Valley Health (GVH) Oncology Unit to describe their clinical presentations and timeliness of management.

Method: This is a retrospective study conducted at GVH Oncology Unit from 1^st February 2012 to 30^th September 2014. Approval was obtained from the GVH Ethics Committee.

Results:

A total of 191 patients with breast cancer of a median age 57 years (range 36 - 82) were identified from the  electronic medical records. Majority (n=118) were newly diagnosed, nearly a quarter (n=45) had their care transferred to GVH and the remaining (n=28) developed recurrence. Only 28% (33) of newly diagnosed patients were detected through screening mammography. 77 percent presented with non-metastatic disease  while 23% had stage 4 disease at diagnosis.   Majority were referred by surgeons (54%), followed by physicians (17%), general practitioners (13%) and other specialists (16%).

Most patients with non-metastatic disease (93%) underwent definitive surgery - 63% were mastectomy; 7  bilateral mastectomies. The median time from biopsy to surgery is 21 days (n=124) while that from referral to first oncology appointment is 20 days (n=170). Nearly two thirds (n=123) received either chemotherapy and/or radiotherapy (n=117). The median time from biopsy to chemotherapy is 63 days (n=102), while that from surgery to chemotherapy is 46 days (n=83). 85% have endocrine positive disease while 18% have HER2-positive disease. Median overall survival of patients with stage 4 disease is 287 weeks (15-1260 weeks).

Conclusion: . Regional patients tend to be older at presentation, diagnosed at a more advanced stage and more often with metastatic disease. Median times will be further analysed. Overall survival is comparable to Statewide data.