IEE: New Zealand Trevor Everett

Auckland, NZ Population: 1.5 million ~60% European, ~20% Asian, ~10% Pacific Islanders, ~10% Maori Language: English

Auckland City Hospital One of the largest hospitals in NZ ~700 beds Radiology department has all major subspecialties Pediatric, MSK, Neuro, IR, Body, Breast, and Nuclear Fantastic coffee atrium

Breast Cancer Screening in NZ Program started in late 90s Government realized lower income female populations were not being screened as routinely as wealthier populations Wanted to address problem so developed national breast screening program (National Screening Unit, NSU)

Why Breast Cancer Screening? As a budding radiologist, I have always been interested in breast cancer screening and decreasing mortality and morbidity in female patients Additionally, I made a great connection working with the breast imager at Auckland City Hospital, Dr. Jeremy Whitlock As I spent more time with him, this felt like a natural topic to pick up to utilize his expertise

National Screening Unit Started in late 90s, expanded after first 5 years to include patients 5 years older and younger than original protocol Resulted in more patients to be screened, more work Has continued to expand and become unified throughout the country, with more clear standards Improved from 30% screening rates to >70% Implementation of MRI has helped in screening process of familial breast cancer

Summary of NSU in NZ Overall, very comparable to screening programs in U.S. and Europe Continues to adapt and improve, both with protocols and technology Implementing more digital breast tomosynthesis (DBT) Adjusting protocols for MRI to ensure only appropriate patients are scanned Great example of how a public health problem can be addressed by the government

Most Profound Clinical Experience Working with the breast imagers and observing their compassion and great interpersonal skills. Seeing firsthand how to interact with breast cancer patients in a meaningful and genuinely caring way. Learning some of the basics to mammography and breast ultrasound.

Most Profound Cultural Experience The Kepler Track 60-kilometer, 3 day/2 night hike through the mountains in Fiordland National Park Met wonderful people along the way Tested my physical abilities and mental endurance

“Iris Burn Hut”, where I stayed the 2nd night.

References https://www.nsu.govt.nz/breastscreen-aotearoa Whitlock, J. (2017, February 21). Personal interview.