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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: March 2018
94.7%
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: March 2018
85.9%
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: March 2018
88.2%
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: 1.13.14

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: March 2018
38.5%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.

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