Resource impact summary report
Guideline recommendations
See NICE's recommendations on advanced breast cancer: diagnosis and treatment.
The following recommendations represent a change to current practice:
- Use of PET-CT as one of the primary imaging tools for staging and diagnosis [recommendations 1.2.1 to 1.2.3]
Financial and capacity resource impact
The key drivers of resource impact are that PET-CT is not currently standard practice in the NHS for staging and diagnosis of advanced breast cancer and there are limited PET-CT machines which tend to be restricted to specialist centres. Current standard practice is for CT scans to be used.
Table 1 shows the difference in tariff price between PET-CT and CT scans.
Table 1 Cost of PET-CT and CT scans
|
Tariff price for PET-CT (HRG RN05A Single Photon Emission Computed Tomography with Computed Tomography [SPECT-CT] of Two or Three Areas, 19 years and over) |
£259 |
|
Tariff price of CT (HRG RD26Z Computerised Tomography Scan of Three Areas, with Contrast) |
£116 |
|
Price difference |
£143 |
|
Cost of performing 1,000 PET-CT scans instead of CT scans |
£143,000 |
The recommendations around systemic anti-cancer therapy and chemotherapy are in line with current practice and existing technology appraisal guidance.
We expect that the resource impact of this update is that PET-CT scans take longer to perform than CT scans, a PET-CT scan takes 30 to 45 minutes to perform while a CT scan takes between 10 and 20 minutes.
Table 2 shows the difference in time taken to perform a PET-CT scan compared to a CT scan.
Table 2 Time taken to perform PET-CT and CT scans
|
Time taken to perform PET-CT scan (minutes) |
30 to 35 |
|
Time taken to perform CT scan (minutes) |
10 to 20 |
|
Minimum difference (minutes) |
10 |
|
Maximum difference (minutes) |
35 |
|
Average difference (minutes) |
17.5 |
|
Time taken to perform additional 1,000 PET-CT scans instead of CT scans (hours) |
292 |
Population covered
Table 3 below shows the number of people with advanced breast cancer each year both at a national level for England and per 100,000 population.
Table 3 Incidence of advanced breast cancer in England
|
Details |
Percentage (%) |
Number of people in England |
Number of people per 100,000 |
|
Adults |
N/A |
47,106,459 |
79,227 |
|
Breast cancer diagnoses (a) |
0.11 |
51,500 |
90 |
|
People with advanced breast cancer on diagnosis (b) |
14.6 |
7,378 |
15 |
|
People with early breast cancer on diagnosis (c) |
85.4 of (a) |
43,157 |
75 |
|
People with early breast cancer who progress to advanced breast cancer in year (d) |
30.0 of (c) |
12,497 |
22 |
|
Total people with advanced breast cancer per year |
N/A (b)+(d) |
20,325 |
37 |
Key information
Table 4 Key information
|
Speciality |
Cancer |
|
Disease area |
Breast cancer |
|
Programme budgeting category |
02F Cancers and Tumours, Breast |
|
Commissioners |
Integrated Care Boards and NHS England |
|
Provider |
NHS Hospital trusts |
About this resource impact summary report
This resource impact summary report accompanies the NICE guideline on advanced breast cancer: diagnosis and treatment and should be read with it.
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