Secondary breast cancer
A Westminster Hall debate on secondary breast cancer will take place on Thursday 11 May 2026. The debate will be led by Clive Jones MP and Mary Kelly Foy MP.
Secondary breast cancer occurs when a cancer that originated in the breast spreads to another part of the body, typically the bones, lungs, liver or brain. It is sometimes referred to as metastatic, or advanced, breast cancer.
The charity Breast Cancer Now notes that secondary breast cancer can occur months or years after primary breast cancer but that there are instances where a secondary cancer is diagnosed at the same time as primary breast cancer.
Secondary breast cancer is made up of breast cancer cells that have spread through the blood or lymphatic system. This means that secondary breast cancer in, for example, the liver, behaves as, and is treated as, breast cancer and not primary liver cancer.
The symptoms of secondary breast cancer depend on exactly where the cancer has spread. More information can be found at Cancer Research UK, Symptoms of secondary breast cancer, July 2023 and Macmillan Cancer Support, Secondary breast cancer symptoms explained, July 2023.
Cancer Research UK explains that secondary breast cancer is different to locally advanced breast cancer. In locally advanced breast cancer, the cancer has spread into surrounding area, such as the skin or the chest muscle, but not to other distant parts of the body such as the bones.
Breast cancer services in EnglandA patient would typically begin their cancer care journey with their GP. If cancer is being considered, the GP would refer the patient for testing and diagnosis.
NHS England is ordinarily responsible for providing specialist cancer services for adults, including chemotherapy and radiotherapy. NHS England also commissions radiotherapy services. For 2025/26, NHS England has delegated some specialised services to ICBs, including chemotherapy and radiotherapy.
How is secondary breast cancer treated?There is no cure for secondary breast cancer. Treatments are available that aim to control the spread of the cancer, reduce and relieve symptoms, and improve quality of life. The nature of the treatment will depend on the location of cancer in the body, how extensive it is, current symptoms and past treatments. Chemotherapy, radiotherapy, hormone therapy and targeted cancer drugs, used either on their own or in combination, are all common treatments. More information on treatment options can be found at Macmillan Cancer Support Secondary breast cancer treatment options ( July 2023), and Cancer Research UK, Treatment options for secondary breast cancer (November 2023).
New drugsMacmillan Cancer Support notes that “treatments for secondary breast cancer are advancing”, meaning that “people are living with the cancer for longer”. Before a treatment is made available via the NHS in England, it must first be granted a marketing authorisation (sometimes referred to as a medicines licence) by the UK medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA). It must also be evaluated by the National Institute for Health and Care Excellence (NICE) to assess both its clinical and cost-effectiveness. More details can be found in the Commons Library briefing on Deciding which medicines are used in the NHS.
Breast Cancer Now has published a list of new drugs for treating breast cancer and secondary breast cancer that have either been recently considered by NICE or are undergoing evaluation: New drugs approved in 2024 and what’s coming up in 2025.
EnhertuAs part of its 2023-24 Future Cancer inquiry, the Health and Social Care Committee held an oral evidence session to examine changes to NICE’s appraisal methods, made in 2022. The committee particularly focused on the appraisal of the drug Enhertu (trastuzumab deruxtecan) for the treatment of some types of secondary breast cancer on the NHS.
NICE has recommended Enhertu for use within the Cancer Drugs Fund for the treatment of HER2-positive unresectable or metastatic breast cancer. Medicines recommended for use via the fund are made available via the NHS while more data is collected on their clinical and cost-effectiveness.
NICE did not recommend Enhertu for the treatment of HER-2 low metastatic and unresectable breast cancer. The government says that NICE is an independent body and did not find that this use of Enhertu would be a “clinically and cost-effective use of NHS resources”.
In a letter to the to the Health Secretary, the committee highlighted concerns from pharmaceutical companies that changes to NICE’s appraisal methodology had made it more difficult to demonstrate the clinical and cost-effectiveness of drugs like Enhertu. It recommended that a particular aspect of NICE’s appraisal methodology, known as the ‘severity modifier’, should be urgently reviewed. The government did not specifically engage with the committee’s point about NICE’s appraisal methodology in its response to the committee’s letter, though it did highlight the (then) forthcoming National Cancer Plan for England.
NICE commissioned a report by the University of Sheffield to evaluate its use of the severity modifier which was published in September 2024. According to NICE, the report found that the new severity weighting was working as “intended and expected”. The government says that NICE had found that the new severity modifier had increased the proportion of medicines that were recommended for use in the NHS, including medicines for advanced cancer patients. In March 2026, the government reported that 85% of medicines for advanced cancer had been approved since the severity modifier was introduced, compared to 69% before. It noted that Enhertu was the only medicine for the treatment of advanced breast cancer that NICE had not recommended since the severity modifier was introduced.
Government policy The National Cancer Plan for EnglandThe National Cancer Plan for England was published on 4 February 2026. It sets a headline target that 75% of cancer patients will survive for 5 years or more after diagnosis, by the year 2035. The plan sets out plans to expand screening and diagnostic testing, meet cancer waiting time standards and address inequalities in cancer care in England.
The plan includes a commitment to “define and count” recurrent cancers, beginning with metastatic breast cancer. The government says that the National Disease Registration Service Get Data Out programme is improving cancer data.
The 10 Year Health Plan for EnglandIn July 2025 the government published its 10 Year Health Plan for England, ‘Fit for the Future’ setting out its plan to “reinvent the NHS through 3 radical shifts”. These are focussed on shifting care from:
- Hospital to community with the introduction of a Neighbourhood Health Service in local communities
- Analogue to digital services to improve the accessibility of health services
- Sickness to prevention to address health issues before they escalate.
The Healthcare Quality Improvement Partnership (HQIP), on behalf of NHS England and the Welsh Government, has commissioned the development and establishment of the National Cancer Audit Collaborating Centre (NATCAN), which is part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP).
Work on setting up the new centre began on 1 October 2022. NATCAN is funded by NHS England and the Welsh Government, with £5.4m for an initial period of three years.
NATCAN delivers ten national cancer audits, one of which is the National Audit of Metastatic Breast Cancer (NAoMe).
NAoMe’s 2025 report notes that an “important issue to address, related to the planning and management of care, is the current lack of information on how many people have metastatic breast cancer.” It further states that “efforts are being made nationally to improve the collection of data […] but planning services and evaluating the quality of care provided is hampered by the inability to follow patients along the care pathway.”
Between 1 January 2020 and 31 December 2022, data completeness for key routine data in England was below the standard of 90% for all metrics recorded by NAoMe for people with de novo (that is, not recurring) metastatic breast cancer.
Measures include various patient and tumour characteristics that are used to inform treatment options.
Data completeness for selected key metrics ranged from 58% to 78% in England. There was also substantial variation between hospital trusts. NAoMe’s data dashboard contains statistics on data completeness for individual trusts.
The report emphasises that “the recording of this clinical information in national cancer datasets is vital to understand patterns of care within the NHS.” NAoMe state that further efforts to improve data completeness should include “identifying a data lead responsible for checking the accuracy and completeness of data being entered, as well as efforts to improve understanding of how to enter […] information correctly.”
Despite being below target, data completeness has overall improved for most measures in the three years between 2020 and 2022.
Prevalence of metastatic breast cancerAccording to NAoMe, between 1 January 2020 and 31 December 2022, just over 10,000 people presented with de novo metastatic breast cancer. 12,750 individuals were diagnosed with recurrent metastatic breast cancer after an initial diagnosis of non-metastatic breast cancer. However, information for people with recurrent breast cancer is poorly collected and ongoing work is being undertaken to improve identification of people with recurrent breast cancer.
The one-year survival rate for people with de novo metastatic breast cancer was 65% and the three-year survival rate was 44% in England and Wales combined.
10% of people with de novo metastatic breast cancer died within 30 days of chemotherapy, compared to 19% with recurrent metastatic breast cancer in England.
Parliamentary material Parliamentary debates6 January 2026 | Westminster Hall
NHS Workforce Levels: Impact of Cancer Patients
23 October 2025| Westminster Hall
Breast Cancer Screening: Bassetlaw
9 June 2025| Commons Chamber
10 December 2024| Westminster Hall
12 November 2024| Westminster Hall
31 October 2024| Westminster Hall
Statements
Improving Cancer Care and Early Diagnosis
26 January 2026 | UIN HCWS1271
Ashley Dalton, Parliamentary Under-Secretary for Public Health and Prevention
Expanded access to cancer treatment
19 January 2026 | UIN HCWS1248
Ashley Dalton, Parliamentary Under-Secretary for Public Health and Prevention
4 February 2025
Andrew Gywnne, Parliamentary Under-Secretary for Health and Social Care
Parliamentary questions23 January 2026 | UIN 108036
Asked by: Liz Jarvis
To ask the Secretary of State for Health and Social Care, what steps he is taking to help ensure that patients with secondary breast cancer have a clinical nurse specialist allocated to them.
Answering member: Ashley Dalton | Department: Department of Health and Social Care
In 2024/25, approximately 8,000 people received training to either enter the cancer and diagnostics workforce or to develop in their roles. As part of this, over 1,600 people were on apprenticeship courses, with over 270 additional medical specialty training places funded. Over 1,000 clinical nurse specialist grants were made available to new and aspiring clinical nurse specialists.
NHS England is also investing in structured career development and education support. The Aspirant Cancer Career and Education Development programme provides a nationally agreed framework for capability, career development, and education for nurses, allied health professionals, and the support workforce working in cancer care. This is also beneficial for the training and development of clinical nurse specialists working in breast cancer care.
Breast Cancer: Medical Treatments
7 January 2026 | UIN 103810
Asked by: Mims Davies
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that people living with incurable secondary breast cancer have timely access to new and effective medicines, including treatments such as Enhertu and Trodelvy.
Answering member: Dr Zubir Ahmed | Department: Department of Health and Social Care
The National Institute for Health and Care Excellence (NICE) is the independent body that makes recommendations on whether new licensed medicines should be routinely funded by the National Health Service based on an assessment of clinical and cost effectiveness.
NICE has recommended Enhertu, also named trastuzumab deruxtecan, for use in the Cancer Drugs Fund for the treatment of women with HER2-positive secondary breast cancer and it is now available for the treatment of eligible patients while further data on its effectiveness is being collected that will inform a NICE decision on routine funding. NICE did not recommend Enhertu for the treatment of HER-2 low metastatic and unresectable breast cancer as a clinically and cost-effective use of NHS resources.
NICE terminated its appraisal of Trodelvy, also named sacituzumab govitecan, for treating hormone receptor-positive HER2-negative metastatic breast cancer after two or more treatments in August 2025, as the company, Gilead, did not provide an evidence submission.
28 October 2025 | UIN 86126
Asked by: Helen Maguire
To ask the Secretary of State for Health and Social Care, if his Department will (a) collected and (b) publish data on people diagnosed with secondary breast cancer in the upcoming NHS cancer plan.
Answering member: Ashley Dalton | Department: Department of Health and Social Care
The Department recognises the importance of robust and timely data on people diagnosed with secondary (metastatic) breast cancer to support service planning and improve outcomes.
Work is already under way. NHS England commissioned clinical audits on metastatic breast cancer to increase the consistency of access to treatments. The National Audit of Metastatic (Secondary) Breast Cancer (NAoMe) results are based on data about people in England and Wales diagnosed and treated for metastatic breast cancer between January 2020 and December 2022. The Department and NHS England are now acting on the audit’s findings.
The National Cancer Plan is due to be published in early 2026. We have received more than 11,000 responses to our Call for Evidence and have had significant ongoing engagement with patients, clinicians, and charities. The Department is working closely with NHS England and cancer registration and audit bodies to ensure that data on secondary breast cancer continues to be collected, analysed and, where appropriate, made publicly available in line with national data standards.
Breast Cancer: Medical Treatments
29 August 2025 | UIN 73468
Asked by: Dan Tomlinson
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential impact of the introduction of the severity modifier by NICE in 2022 on the provision of life-extending treatment to those with incurable secondary breast cancer.
Answering member: Karin Symth | Department: Department of Health and Social Care
The National Institute for Health and Care Excellence (NICE) has been monitoring the impact of the severity modifier since it was implemented in 2022. Data up to March 2025 shows that the proportion of positive cancer recommendations is higher with the severity modifier (85%) than with the end-of-life modifier it replaced (75%). The proportion of positive recommendations for advanced cancer treatments is also higher with the severity modifier (81% compared to 69% with the end-of-life modifier).
Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed. This includes treatments for advanced breast cancer (such as Truqap and Korserdu), which are now available to eligible NHS patients.
The severity modifier is therefore working as intended and there are currently no plans to adjust or change it in the near future. However, NICE has commissioned research on people’s attitudes to how the severity modifier should be applied that will inform future reviews of NICE’s methods.
29 August 2025 | UIN 72231
Asked by: Edward Morello
To ask the Secretary of State for Health and Social Care, whether his Department plans to allocate additional funding to Integrated Care Boards to help improve (a) support and (b) treatment for people living with secondary breast cancer in (i) Dorset and (ii) rural constituencies.
Answering member: Ashley Dalton | Department: Department of Health and Social Care
Improving early diagnosis, access to treatments, and support across England are key priorities for the Government for all cancer types, including for those living with secondary breast cancer in West Dorset and rural constituencies.
To ensure that people diagnosed with secondary breast cancer have timely access to new and innovative treatments, NHS England commissioned a National Audit of Metastatic Breast Cancer, which provides timely evidence for cancer service providers of where patterns of care in England may vary. The purpose of the audit was to identify information to increase the consistency of access to treatments and help stimulate improvements in cancer treatment and outcomes for patients. The National Health Service is now acting on those findings, including for patients in West Dorset.
NHS England is responsible for funding allocations to integrated care boards (ICBs), including those in Dorset and rural constituencies. This process is independent of Government, and NHS England takes advice on the underlying formula from the independent Advisory Committee on Resource Allocation. ICB’s are responsible for commissioning healthcare which best meets the needs of their local populations, including treatment and support for secondary breast cancer.
To improve early diagnosis rates all over the country, including in West Dorset and rural areas, the Department and NHS England are improving public awareness of cancer signs and symptoms, streamlining referral routes, and increasing the availability of diagnostic capacity through the roll-out of more community diagnostic centres. The Department is also committed to improving waiting times for cancer treatment, so that people with cancer, including secondary breast cancer, can get access to the care they need more quickly. The NHS is now delivering an extra 40,000 operations, scans, and appointments each week, as the first step to ensuring early diagnosis and faster treatment.
Breast Cancer: Medical Treatments
29 August 2025 | UIN 71050
Asked by: Lee Anderson
To ask the Secretary of State for Health and Social Care, what recent steps he has taken to improve access to new treatments for patients with secondary breast cancer.
Answering member: Ashley Dalton | Department: Department of Health and Social Care
The Department is committed to ensuring that the National Health Service diagnoses cancer earlier and treats it faster so that more patients, including those with breast cancer, survive.
The National Institute for Health and Care Excellence (NICE) makes recommendations for the NHS on whether new licensed medicines should be routinely funded by the NHS based on their costs and benefits. Cancer medicines are eligible for funding from the Cancer Drugs Fund from the point of a positive NICE recommendation. Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed, including treatments for secondary breast cancer such as Truqap and Korserdu, which are now available to eligible NHS patients.
The National Cancer Plan for England will be published later this year and will set out further details on how we will improve outcomes for all cancer patients, including those with secondary breast cancer. The National Cancer Plan will have patients at its heart and will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and aftercare.
Press materialRecognising the signs of secondary breast cancer (Nursing in Practice, 17 October 2025)
New Poll Shows Lack Of Public Awareness For The Leading Cause of Death For Women Under 60 In The UK (Make 2nds Count, 1 October 2025)
Scientists’ discovery could stop breast cancer spreading (The Times, 28 July 2025)
Charity ‘sounds alarm’ that incurable breast cancer patients face being denied life-extending drugs (Breast Cancer Now, 2 July 2025)
New research to develop blood test that predicts the risk of secondary breast cancer (University of Sheffield, 26 June 2025)
Rhyl mum with secondary breast cancer calls for more support (Rhyl Journal, 9 May 2025)
Cancer pill 'gave me four years of extra time' (BBC News, 11 April 2025)
Clive Jones Wokingham MP talks on breast cancer diagnosis (Bracknell News, 17 March 2025)
Women’s big worry after breast cancer: why does it come back? (The Times, 16 June 2024)
Further readingMake 2nds Count : Giving hope to those affected by secondary breast cancer
Truth be Told Campaign (Make 2nds Count, October 2025)
Recent Breast Cancer Breakthroughs (Worldwide Cancer Research, 16 September 2025)
Ask the Experts: Breast cancer dormancy and late recurrence (Oncology Central, 7 October 2025)