New research shows scale of secondary breast cancer in England

A cancer researcher and consultant has estimated for the first time how many women are living with secondary breast cancer in England – in new research which could help to shape cancer services.

The number of women with breast cancer which has spread – called metastatic or secondary breast cancer – was known to be increasing in other countries but there were no accurate figures for England. Professor Carlo Palmieri, Professor of Translational Oncology at the University of Liverpool and Consultant in Medical Oncology at The Clatterbridge Cancer Centre NHS Foundation Trust, used hospital episode statistics (HES) to estimate the number of people living with metastatic breast cancer in England, how this figure had changed over the previous five years, and the level of clinical activity created in the treatment and care of these people.

The research was published in the journal JAMA Network Open.

For too long, a lack of current data has meant that no-one has understood the real scale of the care, treatment and support needs of these patients
Delyth Morgan

Data already available shows that in 2019, there were 48,387 new cases of breast cancer, with 9,525 recorded deaths of the disease – the vast majority being due to metastatic breast cancer. The new findings from Prof Palmieri’s research – conducted with Joshua Owide and Kirsty Fryer, of Wilmington Healthcare – shows that the number of people living with metastatic breast cancer is on the rise, with a corresponding increase in the number of spells in hospital. The research shows that in 2020-2021 there were 57,215 patients living with metastatic breast cancer. The findings highlight that these numbers have increased steadily over the previous five years, rising from 38,350 in 2016-2017. Overall, the number of hospital spells, an indication of activity in hospitals for these patients, also increased over the five years – from 393,180 in 2016-2017 to 974,320 in 2020-2021.

Professor Palmieri said: “To our knowledge, this is the first time that the number of people living with metastatic breast cancer in England has been estimated. Previous estimations that 35,000 individuals are living with it in the UK are an underestimation, as we have calculated there are 57,000 such people in England alone. The data demonstrates – in keeping with information from Australia and the US – that the prevalence of metastatic breast cancer is increasing over time, reflecting an expanding level of clinical activity and clinical work generated by these patients. Our findings are important as they show the prevalence of metastatic breast cancer using NHS data which is vital in the planning, design, commissioning and delivery of appropriate cancer services and ensuring we have sufficient capacity.”

Baroness Delyth Morgan, Chief Executive of Breast Cancer Now, said: “Today’s new estimate that 57,215 people were living with secondary breast cancer in England in 2020/21 (April 2020 to March 2021) is a landmark moment in understanding the true number of people living with secondary breast cancer in England. For too long, a lack of current data has meant that no-one has understood the real scale of the care, treatment and support needs of these patients. This new research – which suggests that in England alone there are significantly more people living with secondary breast cancer than the gross underestimate of 35,000 across the whole of the UK – illustrates the devastating reality for people living with this incurable disease: they are simply overlooked.

“We’re acutely aware that, too often, people living with incurable breast cancer have felt forgotten at an already frightening and challenging time, with many experiencing long delays in diagnosis, struggling to access vital support from a specialist nurse, and fearing they may not be able to access life-changing treatments. It also suggests that the number of people living with secondary breast cancer in England has been increasing over time, from 38,350 in 2016/17. This again highlights the need for more support for the diagnosis, treatment and care of people living with secondary breast cancer. We know that the NHS is facing immense pressures and challenges, but there has to be a robust plan to support this neglected group of patients.

“This new estimation is a vital first step in better understanding the picture of secondary breast cancer in England. It is further proof of the value of the first NHS funded National Metastatic Breast Cancer Audit, which has now been given the go-ahead in England and Wales after a decade of tireless campaigning by Breast Cancer Now and our supporters. Through gathering vital insight, the Audit will help support the NHS to design and plan services in an informed way. But those plans must be acted on, so that patients receive treatment, care and support that meets their needs, and so that they can live well for as long as possible. It’s vital, however, that audits happen across the whole of the UK. The upcoming Scottish Cancer Strategy presents a crucial opportunity for the Scottish Government to commit to a secondary breast cancer audit.”

Source: University of Liverpool

31.12.2022