October is Breast Cancer Awareness Month, and education and awareness of the disease continues to be vital in driving early detection which helps in improving patient prognosis and clinical outcomes. Globally, cancer diagnostics and breast cancer treatments have advanced significantly to make this possible.
According to The World Health Organisation breast cancer was the most commonly diagnosed cancer in women in 157 countries out of 185 in 2022. In 2022 an alarming 2.3 million women received a diagnosis of breast cancer, and tragically 666 000 lost their lives to this disease. In South Africa, breast cancer continues to dominate, accounting for 23.1% of all cancer cases among women.
Understanding treatment options, which vary by type, location, and stage of cancer, is important for those diagnosed with breast cancer. Knowing the options which can include surgery, chemotherapy, radiotherapy, or a combination provides patients with a sense of control over their treatment.
Various diagnostic tests help in staging cancer and formulating treatment plans. These typically include blood tests, bone scans, CT scans, MRI scans, and positron emission tomography – computed tomography (PET-CT) scans.
PET-CT scans combine PET and CT imaging, a global best practice in nuclear medicine. These scans capture three-dimensional images using a small amount of radiotracer (small amount of a radioactive substance) to detect abnormal metabolism, including breast cancer sites.
“PET-CT combines two types of imaging: detailed CT pictures of the body’s structure and PET images showing cellular activity. Cancer cells are typically more active and show up brightly on the PET scan, a bit like a heat map, making it easier to detect cancer,” says Dr Holger Wellman, Oncology Clinical Lead, Life Healthcare.
The highly sophisticated technology utilised in PET-CT provides a scan that aids specialists to accurately locate tumours or cancerous lesions and assess the extent of disease. This also helps them determine spread for staging and treatment planning.
“Armed with this information from the PET-CT scan, oncology treatment teams can better plan a patient’s cancer management and treatment”, adds Dr Wellman.
While PET-CT scans play an important part in detecting the cancer they can also assist healthcare professionals to evaluate how effective the treatment is and adjust treatment accordingly. This essentially means that specialists can personalise cancer-management plans for each individual. An additional benefit is that PET-CT can also be used to identify whether cancer has recurred after a remission.
International evidence shows that PET-CT scans are more cost-effective and accurate for oncology investigations compared to conventional diagnostic scans.
However, a Life Healthcare research paper has identified a significant gap in the use of PET-CT scans in South African cancer diagnostic and management practices. The country only performs 20, 000 PET-CT scan annually across the private and public sector. Whereas the UK performs 231, 000 annually and Australia, 118, 000 annually.
The report highlights that PET-CT imaging yields better diagnostic results and treatment outcomes for breast cancer compared to conventional methods. It mentions that inconsistent funding and referral pathways are major barriers to wider adoption, and suggests that alternative reimbursement models could help overcome these obstacles.
To align with international best practices, the report recommends integrating PET-CT scans into standard clinical practice in South Africa.
Breast cancer patients should consult their specialists about PET-CT scans and get authorisation from their medical aid before the scan.
For more information on PET-CT scans click here.
