The purpose of the National Audit of Metastatic Breast Cancer (NAoMe) is to evaluate the patterns of care and outcomes for people diagnosed with metastatic breast cancer in England and Wales, and to support services to improve the quality of care for these people. The NAoMe includes all people diagnosed with metastatic breast cancer either at initial diagnosis or at recurrence.
This is the first Quarterly Report published for the NAoMe. Data available to the audit for this were based on patient-level records from the Rapid Cancer Registration Dataset (RCRD) linked to other routine national data.
This Quarterly Report provides an overview of the completeness and quality of key data items provided in the RCRD for people diagnosed with metastatic breast cancer in England between 01 October 2019 and 30 September 2022.
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NAoMe Quarterly Report, October 2019 to September 2022
What additional data has been used to produce this Quarterly Report?
The RCRD is compiled mainly from information collected within the Cancer Outcomes and Services Dataset (COSD). Data in the RCRD are made available more quickly than gold standard Cancer Registration records however, the range of data items available is limited and many data items provided within the Cancer Registration records (and linked cancer datasets) are unavailable. For breast cancer this means information on tumour characteristics such as estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) status is not available. Additionally, the RCRD does not have complete coverage of all people with a diagnosis of metastatic breast cancer within England during the reporting period.
Patient-level records in the RCRD were provided linked to other routine national datasets, including Hospital Episode Statistics Admitted Patient Care (HESAPC) records. The datasets were released to the National Cancer Audit Collaborating Centre (NATCAN) in November (RCRD) and December (HESAPC) 2023, and contain data submitted to the National Disease Registration Service (NDRS) by English NHS trusts for people with a diagnosis of breast cancer between 01 January 2018 and 30 June 2023. For the NAoMe HESAPC data is required to define the cohort of people included, specifically it is currently essential in identifying patients with evidence of metastatic disease within 12 months of diagnosis for whom the cancer stage is not recorded as stage 4.
The NAoMe Quarterly Reports will initially include data quality metrics only. Going forward, the team will continue development work, in consultation with stakeholders, to determine which audit indicators are feasible for quarterly reporting using the RCRD and linked data. These indicators are likely to concern the diagnostic pathway, treatments and outcomes.
Why do these Quarterly Reports focus on data completeness/quality?
The initial focus of the Quarterly Reports is on data completeness as this aspect of data quality underpins what the audit can reliably and robustly report. Data on stage at diagnosis is essential to many elements of the audit, firstly to determine inclusion of each patient, based on the diagnosis of metastatic breast cancer, and secondly to understand treatments and subsequent outcomes.
We encourage all provider teams to review their data completeness and make improvements as this will help ensure the number of patients included in the NAoMe is reflective of the number of people diagnosed with metastatic breast cancer in clinical practice. By focusing exclusively on data completeness for this report, we are aiming to shine a spotlight on areas where improvements are needed.
How have we chosen these specific data items to focus on?
The specific data items reported within this Quarterly Report were chosen based on the availability of information within the RCRD. Stage is essential for accurately identifying and describing the cohort of people with breast cancer, as well as understanding subsequent use of treatments and outcomes. Performance status was chosen as it is important across cancers for assessing the eligibility of patients for different treatments.
For any queries relating to the please contact [email protected].
Last updated: 15 July 2024, 11:02am