Breast cancer in Australia: Screening mammography and over-diagnosis

Joel Werner: So Heidi, where are we about to go into?

Heidi Hilton: We're going into the tissue culture lab. So this is where we spend a lot of our time, we do cell culture experiments growing breast cancer cell lines as well as normal breast tissue. So you can see that we have a bunch of incubators where we store all our cells at 37 degrees, and these are the tissue culture hoods. Any time that we handle the cells it has to be completely sterile, so these tissue culture hoods are where we carry out our sterile work.

Joel Werner: This is Dr Heidi Hilton. She is a breast cancer researcher.

You're listening to the Health Report on RN, I'm Joel Werner, filling in for Norman Swan. And over the next few weeks we're examining breast cancer in Australia in 2013.

Heidi Hilton: So we are in the lab of the breast group at the Westmead Millennium Institute, and our group is interested in understanding how the female hormone progesterone works. So we know that progesterone is critical in normal breast development but we also know that it's a major driver of breast cancer risk, and this is important because it's a component of hormone replacement therapy as well as the oral contraceptive pill.

So my particular interest is looking at how progesterone is involved in cell fate specification. So that's a process where breast stem cells differentiate into different cell types called luminal and myoepithelial cells. And we know that this balance of cells in the breast is much different in normal breast compared to breast cancer, so you only have luminal cells in most breast cancers, but how this happens we don't know, so that's part of my project.

Joel Werner: Heidi's connection to the disease isn't just through her work as a scientist.

Heidi Hilton: About halfway through 2008 I finished my PhD, that was at the Garvan Institute, and I then started applying for jobs overseas. I knew I'd always wanted to do a post doc overseas. Towards the end of 2008 I did manage to get a job in London at the Breakthrough Breast Cancer Institute. I was really excited about that. And then two weeks before we were due to leave I went to the doctor just for a check-up before I made the big move, yes, had all the normal checks that they do, including a breast check, which I had never had done by a doctor before, and she found a lump. So yes, disbelief, shock, yes.

Joel Werner: And you'd never had a mammogram before, never had any type of screening procedure before?

Heidi Hilton: No, I was 29. I had done some breast checks just myself, but I knew it was so unlikely, being that age, and not having a big family historywell, at that stage we thought we had no family history of breast cancer. So no, no official checks prior to that. If you do find a lump, especially in young women, it's not that uncommon because women have lumpy breasts, especially when they are young, and most lumps in that situation are actually not cancer, they are benign. So I was really hoping for that.

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Breast cancer in Australia: Screening mammography and over-diagnosis