Early detection and diagnosis of breast cancer can save lives, but our recent policy report revealed that we are missing opportunities to diagnose breast cancer earlier in the UK. Read on to learn more about the key areas outlined in our report.
The earlier breast cancer is detected, the greater the chance that treatment will be successful. This can be achieved if women are aware of the symptoms of breast cancer, attend screening, and are seen quickly. However, due to a continued lack of leadership in the UK, as well as unprecedented financial and operational pressures in the NHS, we are continuing to miss opportunities to diagnose breast cancer earlier.
Our new report, Good Enough: Breast Cancer in the UK, looks at available data across the whole patient pathway in the UK from prevention and diagnosis, to treatment and care. This report demonstrates that while there is much to celebrate in breast cancer, there is still much more to do.
Workforce shortages in diagnostic capacity
There is a workforce crisis in the screening programme. We have identified this as our most pressing issue in the diagnosis of breast cancer, which we urge the government to address by October 2018.
We know that 15% of mammographer posts are vacant, and between 2015 and 2025, 32% of breast radiologists across the UK are due to retire. This is likely to have a significant impact on the ability of the screening programmes to meet current demand and to introduce any new technologies or ways of working.
There is an urgent need to for clear and sustainable workforce planning to address shortfalls in diagnostic capacity.
April, 25, is a mammographer from North West England. She recently resigned from her job working for the National Breast Screening programme because of the pressures she was facing.
“My department was chronically understaffed and the workload was increasing- patients would regularly have to wait for 3-4 hours only to be rushed through their results, causing them unnecessary anxiety at an already stressful time. There are inconsistencies nationally in terms of training, responsibilities and wage, and the profession continues to struggle to recruit younger female radiographers. Things need to change.”
Screening uptake has been slowly but steadily declining over the past decade. Although attendance at screening currently sits slightly above the 70% target in all four nations, we know that screening is only effective at preventing deaths from breast cancer at a population level if people attend. If screening uptake continues to decline, the screening programme will cease to be clinically and cost effective. We believe that the screening programmes across the UK should do more to promote attendance at breast screening.
We are also learning more about breast cancer and genetic and lifestyle factors that contribute to its development. We hope that these learnings can be used to explore new avenues to tailor lifestyle advice and screening for those at higher risk. In the future, we hope to be able to offer increased screening and other interventions to women identified as high risk to reduce their risk and ensure that any breast cancer they do develop will be diagnosed quickly. We also hope to be able to identify women at lower risk of developing breast cancer and offer them screening and lifestyle advice that is in line with their risk.
Referral waiting times
Currently, in England, 93% of people who present to the GP with a symptom of breast cancer should be referred to see a specialist within two weeks. While this target has generally been met, the English cancer strategy has committed to phasing out the so-called ‘two-week wait’ for breast cancer patients in favour of a blanket ‘four-week-wait’ from urgent referral to diagnosis for all cancers. We are concerned about how this will be implemented, as we do not want to see women with breast cancer facing longer waits as a result.
None of the other UK nations have a referral waiting time target, although Northern Ireland and Wales have ‘ministerial expectations’ that patients will be seen within two weeks. In Northern Ireland, this target has not been met since October 2014 and in Wales, no data at all has been published on the numbers of people currently being seen by a specialist within two weeks.
What needs to be done?
By October 2018, Breast Cancer Now wants to see…
- Governments and the NHS across the UK setting out a long-term vision so that there are enough staff to diagnose breast now, and in the future, who are able to meet an increasing demand for services over the next decade.
- The Northern Irish government set out a clear plan for all people to be seen by a breast specialist doctor within two weeks of being referred with symptoms to a GP.
- The Welsh government should publish data on the numbers of people currently being seen within two weeks of being referred by their GP for breast symptoms.
- The screening programme across the UK should do more to promote attendance at screening.
- More should be done to ensure that people are aware of the signs and symptoms of secondary breast cancer when completing their treatment for primary breast cancer. GPs also need to be supported to identify possible cases of secondary breast cancer and to refer people appropriately.
How you can help
Contact your local politician now to ask them to represent patients with breast cancer where you are.
Help us fix this – your voice is the most powerful one we’ve got.