Mark Sibbering

Session 1 Smarter and Better 0900 – 0915

Title: The Safe Introduction of a Breast Pain Pathway

Breast pain is not a symptom of breast cancer, yet in England approximately 20% of 2-week wait (2WW) breast referrals are for breast pain alone. BSBR guidance states that “Breast pain is not an indication for breast imaging”, yet many women continue to be imaged in 2WW clinics.

The National Cancer Plan for England published in February 2026 mandated the introduction of dedicated breast pain clinics to deliver diagnostic pathway improvement by 2027. The East Midlands Breast Pain Pathway (EMBPP) is included as a Case Study in the Cancer Plan.

The EMBPP was developed for women presenting with breast pain alone and has four key components:

·         Emphasising that breast pain has no relationship to breast cancer

·         Clinics held in a Community / Primary Care setting

·         Clinical assessment by an experienced breast clinician

·         Family history risk assessment

The pathway aims to improve the patient experience whilst also freeing capacity in secondary care diagnostic breast clinics including avoiding unnecessary breast imaging.

The presentation will include:

·         a detailed description of the pathway

·         the results of an evaluation of the implementation of Community Breast Pain Clinics at multiple sites in England including safety and cost-effectiveness data

·         signposting of available resources:

Patients and public: 

https://eastmidlandscanceralliance.nhs.uk/patient/east-midlands-breast-pain-pathway-patientpublic

Healthcare professionals:

https://eastmidlandscanceralliance.nhs.uk/professional/east-midlands-breast-pain-pathway-register

Session 2 Metastatic Breast Cancer 1200 - 1215

Title: The National Audit of Metastatic Breast Cancer (NaoMe)

The National Audit of Metastatic Breast Cancer (NAoMe) aims to report on all patients diagnosed with metastatic breast cancer (also known as secondary, advanced or stage 4 breast cancer) in NHS hospitals in England and Wales.

It builds on the work of the National Audit of Breast Cancer in Older Patients (NABCOP) and includes women and men of all ages, with metastatic disease diagnosed at presentation, as well as those with recurrent metastatic disease.

One of the challenges the audit faces is identifying those patients with recurrent metastatic breast cancer; previous work from the NABCOP found that although these data are part of routine data collection in both England and Wales, they are often poorly recorded.

The initial focus of the audit is on improving the completeness of key data items, including recording of cancer recurrence, to ensure all patients living with MBC are counted. The audit aims to establish a baseline from which change in practice and outcomes can be measured and to define a range of outcomes that are important for patients and feasible to measure using national routine data.

The long-term aim is to look to reduce variation in practice and improve aspects of care and outcomes highlighted as important within the scoping work.