A study funded by Sarcoma UK has found that breast sarcoma patients treated in a non-specialist sarcoma centre are more likely to require multiple operations to treat their cancer.
The researchers, based at University College London Hospital, analysed data collected for the 684 patients diagnosed with a breast sarcoma between 2013 and 2018. They found that 26% (about 1 in 4) people treated in a specialist centre needed more than one operation to treat their sarcoma. But for patients not treated in a specialist centre, 41% (more than 4 in 10) needed to have surgery more than once.
A specialist centre is a hospital or clinic with the multi-disciplinary expertise needed to diagnose and treat sarcomas. There are over 15 specialist centres in England, where the study was carried out. The National Service Specification for Sarcoma, which organises sarcoma care in England, sets out that “all people with a suspected or confirmed diagnosis of sarcoma must be referred to the Specialist Sarcoma Centre for review by the sarcoma MDT”, but that once a treatment decision has been made, this can be performed elsewhere.
According to the analysis, only 1 in 3 patients have their first operation at a sarcoma specialist centre. Breast sarcomas require a biopsy (taking a small sample of the sarcoma) to make a correct diagnosis. The team’s research also showed that patients who had a biopsy before their surgery were less likely to require multiple operations to treat their sarcoma. 83% of people managed in a sarcoma specialist centre had a biopsy prior to surgery. But at non-specialist centres, a biopsy was carried out in only 72% of patients. The researchers say that their results show the importance of ensuring patients receive a diagnostic biopsy before their surgery.
The analysis was carried out using data collected by the National Cancer Registration and Analysis Service, an NHS body responsible for collecting and analysing data about cancer patients’ treatment in England. Until now, there has never been a thorough analysis of breast sarcoma patients’ treatment.
Based on their findings, the researchers say that patients who may have a breast sarcoma should be referred to a sarcoma specialist centre as early as possible, and that any surgery they need is also carried out at a specialist centre.
“This important analysis, which uses nationally-collected sarcoma data, has for the first time, provided data on incidence and outcomes of breast sarcoma in England and very valuable insights into its treatment, which is of great value to the sarcoma community,” says report co-author, Dr Mahbubl Ahmed.
“The paper recommends that all patients with a breast sarcoma are discussed in a specialist sarcoma MDT and surgery should be performed in designated sarcoma centres whenever possible.”
You can read the full scientific analysis here.
You can read more about our work to support sarcoma patients’ access to specialist centres, and about the research we have funded, on our website.
