Cancer Medicines Outcomes Programme (CMOP-PHS) clinical reports
Systemic anti-cancer therapy for adults with breast cancer in Scotland SACT for early breast cancer 2020-2024

About this release

This release by Public Health Scotland (PHS) is a Cancer Medicines Outcomes Programme-Public Health Scotland collaboration and uses information from the National SACT Dataset.

This work was requested by the Scottish Cancer Network (SCN) to support the development of clinical management pathways (CMP) for systemic anti-cancer therapy (SACT) use in early breast cancer in Scotland. Please note that since this work was undertaken, the Scottish Cancer Network has reorganised into the NHS Scotland Cancer Collaborative (NSCC), though their function remains the same. (read more about the NSCC).

The primary aim of this work was to describe how SACT is used for the treatment of patients with early breast cancer in NHS Scotland. The secondary aim was to assess tolerability of dose dense (DD) and standard dose (SD) epirubicin + cyclophosphamide (EC) regimens, where possible. Patients were identified using the National SACT dataset linked to other healthcare datasets held in PHS.

This work had two parts with separate objectives:

Part 1: First SACT for early breast cancer

The aim of Part 1 was to describe the treatment landscape for early breast cancer and describe the use of SACT between 1st January 2020 to 30th June 2024 across NHS Scotland, using electronic record linkage.

The objectives were to:

• Identify patients prescribed SACT for early breast cancer.​
• Summarise baseline characteristics of patients prescribed SACT for early breast cancer.
• Report the first SACT regimens prescribed for patients with early breast cancer. ​

Part 2: Comparison of EC regimens

The aim of Part 2 was to describe the use of dose dense (DD) and standard dose (SD) epirubicin + cyclophosphamide (EC) regimens for the treatment of early breast cancer patients in NHS Scotland between 1st January 2020 to 30th June 2024, and to assess if DD EC regimens are associated with a higher incidence of dose delay (as a surrogate for tolerability) or a reduced likelihood of completing treatment.

The objectives were to:

• Summarise the baseline characteristics of patients prescribed SD EC and DD EC for treatment of early breast cancer.
• Describe the treatment pathways after EC, for patients prescribed SD EC and DD EC for treatment of early breast cancer.
• Describe the treatment delay incidence for patients prescribed SD EC and DD EC for treatment of early breast cancer.