
The National Audit of Primary Breast Cancer (NAoPri) and the National Audit of Metastatic Breast Cancer (NAoMe) build on work by the National Audit of Breast Cancer in Older Patients (NABCOP), which was run by the same team as established the NAoPri and NAoMe, from 2016-2022.
The work of the NABCOP and lessons learned inform the planning, methodology and delivery of the NAoPri and NAoMe.
Key outputs produced by the NABCOP team up until 2024 – including reports and journal publications – are described below and available to download.
NABCOP Annual Reports 2016-2022
Fitness assessment for older patients in breast clinic
The NABCOP recommends that patients aged 70 and over who are attending breast clinic for the first time have their fitness assessed to help guide the best course of treatment. We have developed a form which records three different aspects of patient health: The Clinical Frailty Scale (CFS), The Abbreviated Mental Test Score (AMTS), and three screening clinical questions on whether a patient has any major diseases e.g. dementia, cardio-respiratory disease, cancer.
Click on the image below for full details and to download the fitness assessment form:

The NABCOP guide to the breast cancer pathway for older women
We have worked with our patient and charity representatives to develop a two-sided guide, designed to encourage conversations between patients and their breast care team.
The guide is particularly relevant to women aged 70+ diagnosed with breast cancer, with question prompts for patients to discuss key elements of their care and treatment.
Click on the image below for full details and to download the guide:


Setting a track record ‘highly commended’ excellence in patient engagement and involvement in breast cancer audit
The NABCOP achived excellence in patient engagement and involvement, from the perspective of the commissioner HQIP and the patient charities and representatives on the audit oversight groups involved in the audit.
The audit was highly commended by the Richard Driscoll Memorial Award 2022, for an excellent patient involvement programme and co-produced resources.
The Richard Driscoll Memorial Award celebrates great public and patient involvement in the national clinical audit and patient outcomes programme (NCAPOP), and is presented to the HQIP commissioned programme that has been judged to have best demonstrated that they have meaningful engagement with patients, carers and families embedded in their work.
Feedback from the judging panel included: “The NABCOP is very patient-focused, with a well defined approach to patient engagement and involvement that has clearly thought about how to support a niche group of patients. The co-produced clinic guide was specifically mentioned as a positive, as was the fact that live surveys were used to gather feedback on the impact and value of the resources. The annual report, with a separate explainer report for patients and the public, is good.”
Charities as well as individual patients have been engaged and involved.The NABCOP’s submission to the award is available on the HQIP website, or by clicking the image below.

Journal publications
2025
- Important lessons learnt from the National Audit of Breast Cancer in Older Patients (NABCOP) – being drafted
2024
- Survival following adjuvant trastuzumab-based treatment among older patients with HER2-positive early invasive breast cancer – EJC – 14 September 2024
- Survival outcomes after breast cancer surgery among older women with early invasive breast cancer in England – BJS Open – 2 July 2024
2023
- Mastectomy patterns for early invasive breast cancer in England and Wales – Journal of Geriatric Oncology – 1 November 2023
- NICE-recommended oncological drug therapy utilisation – British Journal of Cancer – 23 September 2023
- Treatment-related acute toxicity with adjuvant systemic treatment for HER2-positive early invasive breast cancer – BMJ Oncology – 5 September 2023
- Variation in PMRT for early invasive breast cancer in England and Wales – Clinical Oncology – 25 August 2023
- Recording of endocrine therapy in routine primary and secondary care data – Cancer Epidemiology – 19 July 2023
- Recording of cancer drug therapy in routine secondary care data – Cancer Epidemiology – 14 February 2023
- Association between survival and receipt of PMRT for early invasive breast cancer – Clinical Oncology- 9 February 2023
2022
- Ultra-hypofractionated radiotherapy for early breast cancer – Clinical Oncology – 30 May 2022
- The association between guideline adherence, age and overall survival among women with non-metastatic breast cancer – Cancer Treatment Reviews – 13 February 2022
2021
- Surgical decisions in older women with early breast cancer: patient and disease factors – British Journal of Surgery – 22 March 2021
2020
- Treatment variation in early breast cancer in the UK – The British Medical Journal – 1 December 2020
- Influential factors on treatment for older women with triple negative breast cancer in England – European Journal of Surgical Oncology – 1 October 2020
- Costs of early invasive breast cancer in England – Value in Health – 28 July 2020
- Adjuvant chemotherapy & trastuzumab for HER2-positive early invasive breast cancer – Journal of Geriatric Oncology – 1 June 2020
- Secondary Care Administrative Records Frailty (SCARF) Index – BMJ Open – 6 May 2020
2019
- Addressing frailty in patients with breast cancer: A review of the literature – European Journal of Surgical Oncology – 12 August 2019
- Surgery and adjuvant radiotherapy for unilateral ductal carcinoma in situ (DCIS) in women aged over 70 years: A population based cohort study – European Journal of Surgical Oncology – 7 March 2019
For any queries relating to this information please contact [email protected]