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McGRATH BREAST
HEALTH INDEX
A report into breast health understanding
among women in Australia
McGRATH BREAST HEALTH INDEX My big dream, my pipe dream, would be for every
family in Australia to have access to a breast care
nurse and that one day the next generation of
Aussies our children will know the importance of
checking their breasts and being vigilant and looking
after themselves because I dont want our daughters
growing up thinking, breast cancer cant happen to
me, because I was 31 and I know that it can happen.
- Jane McGrath
FOREWORD
Breast awareness is a term thats used a lot, particularly For the second year running the results reveal a
around October, which is known internationally as disconnect between belief and reality when it comes to
Breast Cancer Awareness Month. Many women consider the nations breast health. Almost three quarters (73%)
themselves breast aware, without giving much thought of Australian women believe they are breast aware, yet
to what that actually means. Jane McGrath was my best fewer than one in five (16%) fulfil the four criteria to be
friend, and one of her aims in setting up the Foundation classified a breastpert.
was to increase breast awareness in Australia, but
As a mother though, I found this years results
especially in young women.
particularly heartening as they show the importance
of talking to your daughters about breast health,
At the McGrath Foundation were determined to make
with women who first learnt about the importance of
real change in the community. This is the second year of
breast health from their mother more likely to check
the McGrath Breast Health Index a measure of what
their breasts regularly. Interestingly, women who have
were calling breastpertise. Breastpertise, or good breast
spoken to their mother about both breast awareness and
health understanding, measures four key criteria that
puberty are significantly more likely to qualify for all four
can effect real change to a womans (and mens) health index criteria (26% vs 16% overall).
outcomes. The Index measures awareness of course, but
also confidence, knowledge and behaviour. These are I know I have always instilled in my daughters the
defined broadly as: importance of good breast health understanding and I
encourage other parents to do the same.
How breast aware does a woman consider
herself to be? We like to say, If you grow them, know them! While
this research focuses on women, the outcomes are
How confident is a woman that shell be applicable to all people in Australia although its
able to identify changes in her breast? primarily a disease that affects women, around 150 men
are diagnosed with breast cancer each year as well.
Does she know the risk factors for breast This research shows that knowing your breasts is a lot
cancer, and can she accurately recognise more than simply being breast aware. We hope that this
myths about causes of the disease? research helps people across Australia take responsibility
for their breast health educate themselves, and have
What is her behaviour, or how frequently is
the right conversations, to build a new generation of
she checking her breasts for changes?
breastperts.
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McGRATH BREAST HEALTH INDEX
#1
AWARENESS
#2
CONFIDENCE
#3
KNOWLEDGE
#4
BEHAVIOUR
Do they consider Are they confident in their Are they knowledgeable Are they checking their
themselves aware of their ability to detect changes about the risk factors for breasts frequently enough
breast health? in their breasts? breast cancer? to detect changes?
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McGRATH BREAST HEALTH INDEX
RESEARCH FINDINGS
The research aims to gain a robust and thorough The key findings reveal that, although the majority of
understanding of the factors impacting on good breast women consider themselves to have good or very good
health understanding, or breastpertise, and to identify breast awareness, fewer than one in five fulfilled all four
common factors that contribute to women scoring criteria to be considered a breastpert. This is similar to the
higher (or lower) on the McGrath Breast Health Index. By 2016 results, both in overall Index outcome and for each of
conducting this research annually, over time the McGrath the individual criteria.
Foundation will be able to offer people in Australia a clear
A key point of note is that the Knowledge criteria changed
view of trends in breastpertise and ideally, assess this
in 2017. The changes reflect the nature of ongoing
against trends in screening and early diagnosis.
research and understanding of cancer risk factors, and it
A series of questions were asked about Awareness, is anticipated that this section will change from time to
Confidence, Knowledge and Behaviour in terms of time in years to come to reflect updated, evidence-based
breast health, which were then supplemented by questions information.
relating to age, geography, parental status and experience
with breast health education. This enabled us to draw
conclusions about the characteristics that are more or less
likely to make women greater breastperts.
Strong family history of breast Using deodorant Strong family history of breast Using deodorant
cancer cancer or ovarian cancer
Wearing an underwire bra Wearing an underwire bra
Being a woman Being a woman
Bumping or bruising the breast Bumping or bruising the breast
Growing older Growing older
Topless sunbathing Topless sunbathing
Being a smoker Tobacco smoke
Implants & breast reductions Implants & breast reductions
Drinking alcohol Drinking alcohol
Giving birth Child bearing
Starting menstruation early, or Starting menstruation early, or
starting menopause late Breastfeeding starting menopause late Breastfeeding
Having large breasts Being overweight after Having large breasts
Having a nipple piercing menopause
It is also worth noting that although having a nipple piercing and sleeping in a bra have been removed from the list of non-
risk factors, there is no evidence to suggest that these activities are risk factors for developing breast cancer simply that
Cancer Australia has not come across any research to show that they are not risk factors.
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McGRATH BREAST HEALTH INDEX
16%
73% Only 16% of women fulfil all four
criteria: awareness, confidence,
26%
knowledge, behaviour
73% of women consider 26% of women who spoke to
themselves to be somewhat or their mother about both breast
very breast aware awareness and puberty could be
considered breastperts
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McGRATH BREAST HEALTH INDEX
#1
AWARENESS
Being breast aware is about knowing how your
breasts look and feel, and knowing what is normal
Very breast aware
Somewhat breast aware
for you. To what extent would you consider yourself
to be breast aware?
QUESTION:
#3
KNOWLEDGE
To what extent do you agree or disagree that the following will make a person more susceptible
to developing breast cancer?
Correctly identify six or more of the below as risk factors: AND does not identify four or more of the
below [non-risk factors] as risk factors:
Strong family history of breast cancer or ovarian cancer
Being a woman Using deodorant
#4
BEHAVIOUR
How often would you say you examine your breasts,
including feeling for lumps or changes?
Once a day
Once a week
Once a fortnight
Once a month
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McGRATH BREAST HEALTH INDEX
#1
AWARENESS
#2
CONFIDENCE
#3
KNOWLEDGE
#4
BEHAVIOUR
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McGRATH BREAST HEALTH INDEX
#1 Awareness 73%
73%
#4 Behaviour 52%
52%
#3 Knowledge 39%
40%
2016 2017
While the results from 2017 did show some minor The research examined other factors that may contribute
differences in percentages of the groups qualifying for to breastpertise, including whether respondents had
criteria, the patterns are similar, and there were very daughters older than 10 years (expecting that they may
few statistically significant differences, highlighting a have had conversations about body image, health and
consistency across both years. Both years results show changes through puberty), whether respondents had
that knowledge of risk factors is low, as is confidence conversations with their own mothers about breast
in being able to detect changes. As the Foundations health, and whether they had personal experience of
education programme addresses this divide in breast breast cancer either themselves, or someone they know,
health understanding, in time, significant trends should being diagnosed with breast cancer.
become apparent.
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McGRATH BREAST HEALTH INDEX
Index criteria among those who have been to the doctor with a breast issue
#1 Awareness 73%
84%
#4 Behaviour 52%
57%
#3 Knowledge 40%
43%
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McGRATH BREAST HEALTH INDEX
Women who first learnt about breast awareness from their mother (or female
guardian) were more likely than those who learnt from the media to meet three
or four criteria of the McGrath Breast Health Index.
Where women first learn about breast awareness has an impact on the
Behaviour criteria more than any other. Women who first learnt of the
importance of being breast aware from their mothers are more likely to check
their breasts regularly, while those who learnt from the media are less likely.
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McGRATH BREAST HEALTH INDEX
KNOWLEDGE IS POWER
In the James family, Mum Belinda had always been a With the support of her McGrath Breast Care Nurse,
proactive breast checker, and after discovering a lump at Elaine, Belinda worked with her physician to create a
the age of 44, made it a priority to discuss breast health recommended long term plan of action for her daughters,
with her two daughters. then aged 16 and 18. The plan includes regular checks,
knowing and acting on the risk factors for breast cancer
After the diagnosis of breast cancer Belinda set up her
and a plan to commence ultrasounds and mammograms
teenaged daughters, Charlotte and Olivia, with a plan to
10 years before they reach the age their mother was
look after their breast health well into the future.
when she was diagnosed.
At the time, I didnt know what was going to happen
Now in their mid-twenties, seven years after their
to me and I wanted my girls to be taken care of, and
Mums initial diagnosis, breast health understanding is
to be on the lookout for themselves, no matter what
something Charlotte and Olivia are very aware of, and
happened.
they continue taking the steps laid out by their doctor to
protect their long term health and wellbeing.
McGRATH BREAST HEALTH INDEX
QUESTION
The four criteria of Being breast aware is
about knowing how your
the McGrath Breast breasts look and feel, and
Health Index knowing what is normal for
you. To what extent would
you consider yourself to be
breast aware?
#1
AWARENESS
AWARENESS
Almost three quarters of women in Australia considered
Women who consider themselves
themselves to be somewhat or very breast aware, which
is a replication of the results in 2016. Among 20-40 year
Breast Aware
olds, there was a significant increase in the number of 2017 2016
women who consider themselves breast aware.
16-19 yrs 50% 67%
Only half of those aged 16 to 19 consider themselves to
be breast aware, which is both significantly lower than
the total population and a significant decline compared
20-30 yrs 67% 60%
with 2016 for this age group. However, it is possible that
this is an anomaly, as patterns across the other age 31-40 yrs 70% 64%
groups remain similar over the two years. This will be
reviewed in years three and four to determine whether 41-50 yrs 75% 73%
there is a trend, and the factors that might contribute to
this.
51-60 yrs 79% 81%
Women with daughters aged 10 years or older
61 yrs and over 80% 85%
were significantly more likely than the total
sample to consider themselves breast aware.
Significantly different to Total
sample at 95% confidence level
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McGRATH BREAST HEALTH INDEX
QUESTION
How confident are
you that you would
be able to detect
a change in your
breasts?
#2
CONFIDENCE
CONFIDENCE
Around 60% of women feel confident that they would
be able to detect a change in their breasts, on par with Women who consider themselves Confident
the 2016 results. Similar to self-classification of breast
awareness, women aged 16-19 years are the least likely 2017 2016
to consider themselves confident. Women aged 61 or
more are most likely to consider themselves confident, Live in capital city 58% 60%
which may also reflect the findings that showed women
who had experienced a breast issue and seen a doctor Live in non-capital 60% 66%
about it considered themselves more confident. city
No significant differences were seen by state or other
demographics other than once again, women with Have a 63% 64%
daughters aged 10 or more were more likely to consider daughter(s) 10-19
themselves confident in detecting changes. Interestingly,
across 2016 and 2017 combined, women outside of Have a 68% 69%
capital cities were more likely to consider themselves
daughter(s) 10+
confident than their metropolitan counterparts.
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McGRATH BREAST HEALTH INDEX
QUESTION
To what extent do you
agree or disagree that
the following will make a
person more susceptible
to developing breast
cancer?
#3
KNOWLEDGE
KNOWLEDGE
Respondents were provided with a list of 19 possible risk factors, of which 11 have scientific evidence and are accepted risk
factors for developing breast cancer. The remaining eight were incorrect or myths. To qualify for the Knowledge criteria of
the Index, women had to correctly identify six or more of the 11 accepted risk factors, AND not incorrectly identify four or
more of the non-risk factors as risk factors.
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McGRATH BREAST HEALTH INDEX
QUESTION
How often would
you say you examine
your breasts,
including feeling for
#4 lumps or changes?
BEHAVIOUR
BEHAVIOUR
Around half of all Australian women check their breasts at least once a month, which is consistent with the 2016 results.
Interestingly, there are still more women who consider themselves confident that they could detect a change in their
breasts (59%) than actually do check their breasts regularly (52%). This pattern is also consistent with 2016.
More than 25% check their breasts less than once a year or have never checked their breasts.
Women who are 40 years or younger are significantly more likely to say they
dont examine their breasts because they dont know how.
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McGRATH BREAST HEALTH INDEX
Your choice of clothing/ 37% 53% 38% 36% 37% 30% 37%
hairstyles
Puberty 35% 52% 43% 33% 36% 30% 25%
Your choice of partner 26% 26% 31% 27% 28% 16% 28%
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McGRATH BREAST HEALTH INDEX
CONVERSATIONS AT THE
SAME TIME AS PUBERTY
For the first time in 2017 questions were asked This indicates an opportunity to start bridging the
specifically about conversations on puberty. Of the knowledge divide in breast health understanding by
population, 14% have had a conversation with their facilitating and encouraging conversations between
mother about both breast health and puberty; in a mums and daughters about breast awareness and
quarter of these cases the conversation happened at the puberty.
same time.
Index criteria among those who have had a conversation with their
mother about breast awareness and puberty
% who qualify for each individual criterion
Awareness 73%
85%
Behaviour
52%
70%
Knowledge
40%
50%
2016 2017
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McGRATH BREAST HEALTH INDEX
The results of the 2017 McGrath Breast Health Index highlight again
the importance of conversations between mothers and daughters
about their breast health.
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McGRATH BREAST HEALTH INDEX
CONCLUSION
The McGrath Breast Health Index once again reveals Crucially, women who have had conversations with their
the importance of looking beyond breast awareness, mothers about both breast awareness and puberty
to the other factors that contribute to breastpertise, or are more likely to score highly on the Index than any
good breast health understanding, and ultimately better other group. With studies showing the onset of puberty
health outcomes. Confidence that women (and men) will occurring earlier than before in some cases1, its crucial
recognise changes in their breasts, knowledge of the risk that age-appropriate conversations about breast health,
factors for developing breast cancer, and behaviour in and changes in the body (including the breasts) are
terms of how regularly women self-examine their breasts considered when having discussions about puberty.
are equally important.
With the McGrath Breast Health Index highlighting that
The 2017 results are only the second year of the McGrath in 2017 only 16% of women in Australia can be considered
Breast Health Index. Yet this years results both confirm breastperts, the challenge is to move the population
the disconnect in breast health understanding among closer to being breastperts over time. Recognising that
women in Australia, and that mothers have a crucial role awareness is the most common factor acknowledged
to play in educating the next generation. by women in Australia indicates that education needs
to focus on building confidence, increasing knowledge
and improving behaviour. The need to build an accurate
knowledge base of risk factors for breast cancer is
of obvious importance. Over the years, the Index will
provide an accurate tracking measure on breastpertise in
Australia.
1
Aksglaede, L., Sorensen, K., Petersen, J.H., Skakkebaek, N.E., Juul, A., 2009,
Recent decline in age at breast development: the Copenhagen puberty study,
Pediatrics, May 2009, Vol 123, Iss 5
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McGRATH BREAST HEALTH INDEX
TOGETHER,
WE CAN
MAKE A
DIFFERENCE
Web www.mcgrathfoundation.com.au