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Early and locally advanced breast cancer: diagnosis and management [NG101]

Measuring the use of this guidance

Recommendation: 1.2.2

All people with breast cancer should have a named clinical nurse specialist or other specialist key worker with equivalent skills, who will support them throughout diagnosis, treatment and follow‑up. [2009, amended 2018]

What was measured: Proportion of breast cancer patients who reported being given the name of a Clinical Nurse Specialist who would support them through their treatment.
Data collection end: June 2015
94.4%
Data collection end: June 2016
94.4%
Data collection end: June 2017
94.7%
Data collection end: June 2018
94.5%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.
What was measured: Proportion of breast cancer patients who reported finding it easy to contact their Clinical Nurse Specialist.
Data collection end: June 2015
85.3%
Data collection end: June 2016
85.9%
Data collection end: June 2017
85.9%
Data collection end: June 2018
84.9%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.
What was measured: Proportion of breast cancer patients who reported that, when they had important questions to ask a Clinical Nurse Specialist, they got answers they could understand all or most of the time.
Data collection end: June 2015
88.3%
Data collection end: June 2016
88.6%
Data collection end: June 2017
88.2%
Data collection end: June 2018
88%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.
What was measured: Of those with data recorded, proportion of women aged 50 and over diagnosed with breast cancer who were seen by a breast clinical nurse specialist or named key worker.
Data collection end: December 2018
85%
Area covered: England and Wales
Source: Royal College of Surgeons. National Audit of Breast Cancer in Older Patients.
What was measured: In England, the proportion of women with breast cancer who had contact with a clinical nurse specialist.
Data collection end: July 2018
95%
Area covered: England and Wales
Source: Royal College of Surgeons. National Audit of Breast Cancer in Older Patients.

Recommendation: 1.6.6

Consider adjuvant therapy after surgery for people with invasive breast cancer, and ensure that recommendations are recorded at the multidisciplinary team meeting. [2009]

What was measured: Proportion of women diagnosed with early invasive breast cancer who had surgery and radiotherapy.
Data collection end: July 2018
89%
Area covered: England and Wales
Source: Royal College of Surgeons. National Audit of Breast Cancer in Older Patients.

Recommendation: 1.7.1

Treat people with invasive breast cancer, irrespective of age, with surgery and appropriate systemic therapy, rather than endocrine therapy alone, unless significant comorbidity precludes surgery. [2009]

What was measured: Proportion of women aged 50 to 69 diagnosed with early invasive breast cancer who had mastectomy or breast conserving surgery.
Data collection end: December 2016
96%
Area covered: England and Wales
Source: The Royal College of Surgeons. National Audit of Breast Cancer in Older Patients.
What was measured: Proportion of women aged 70 or over diagnosed with early invasive breast cancer who had mastectomy or breast conserving surgery.
Data collection end: December 2016
76%
Area covered: England and Wales
Source: The Royal College of Surgeons. National Audit of Breast Cancer in Older Patients.
What was measured: Proportion of women aged 50 to 69 diagnosed with early invasive breast cancer who had mastectomy or breast conserving surgery.
Data collection end: July 2018
95%
Number that met the criteria: 65477 / 68613
Area covered: England and Wales
Source: Royal College of Surgeons. National Audit of Breast Cancer in Older Patients.
What was measured: Proportion of women aged 70 or over diagnosed with early invasive breast cancer who had mastectomy or breast conserving surgery.
Data collection end: July 2018
74%
Number that met the criteria: 29796 / 40405
Area covered: England and Wales
Source: Royal College of Surgeons. National Audit of Breast Cancer in Older Patients.

Recommendation: 1.8.1

For people with breast cancer of sufficient risk that chemotherapy is indicated, offer a regimen that contains both a taxane and an anthracycline. [2018]

What was measured: Proportion of women with ER-negative, HER2-negative N+ early invasive breast cancer who received surgery and adjuvant chemotherapy.
Data collection end: July 2018
53%
Area covered: England and Wales
Source: Royal College of Surgeons. National Audit of Breast Cancer in Older Patients.

Recommendation: 1.8.4

Offer adjuvant trastuzumab for people with T1c and above HER2‑positive invasive breast cancer, given at 3‑week intervals for 1 year in combination with surgery, chemotherapy and radiotherapy as appropriate. [2009, amended 2018]

What was measured: Proportion of women with HER2-positive early invasive breast cancer who received surgery and adjuvant chemotherapy plus trastuzumab.
Data collection end: July 2018
59%
Area covered: England and Wales
Source: Royal College of Surgeons. National Audit of Breast Cancer in Older Patients.

Recommendation: 1.13.4

People who have had treatment for breast cancer should have an agreed, written care plan, which should be recorded by a named healthcare professional (or professionals). A copy should be sent to the GP and a copy given to the person. This plan should include: •designated named healthcare professionals •dates for review of any adjuvant therapy •details of surveillance mammography •signs and symptoms to look for and seek advice on •contact details for immediate referral to specialist care and •contact details for support services, for example, support for people with lymphoedema. [2009]

What was measured: Proportion of breast cancer patients who reported that they had been given a care plan.
Data collection end: June 2018
38.9%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.

Recommendation: 1.13.14

People who have had treatment for breast cancer should have an agreed, written care plan, which should be recorded by a named healthcare professional (or professionals). A copy should be sent to the GP and a copy given to the person. This plan should include: • designated named healthcare professionals • dates for review of any adjuvant therapy • details of surveillance mammography • signs and symptoms to look for and seek advice on • contact details for immediate referral to specialist care and • contact details for support services, for example, support for people with lymphoedema. [2009]

What was measured: Proportion of breast cancer patients who reported that they had been given a care plan.
Data collection end: June 2015
34.7%
Data collection end: June 2016
36.6%
Data collection end: June 2017
38.5%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.

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