Hansard

I thank my colleague Emma Harper for bringing this debate to the chamber. Secondary breast cancer occurs when cancer cells spread beyond the breast, often months or years after the primary diagnosis. It can also be found at the same time or even before the primary cancer. By the end of 2023, for 4,202 patients in Scotland, it was their initial diagnosis.

Despite the Scottish Government’s commitment in its 2016 strategy, “Beating Cancer: Ambition and Action”, and in its “Cancer Action Plan for Scotland 2023-2026” to improve data collection on secondary and metastatic cancers, data for secondary breast cancer is currently not routinely or consistently collected across Scotland. Public Health Scotland’s estimates only count people who had secondary breast cancer as their initial diagnosis and do not count diagnosis following a recurrence or spread of the disease. That is concerning, because breast cancer is one of the leading causes of death for women under 50.

We could reduce that statistic if data was collated both from those who were initially diagnosed with secondary breast cancer and from those who developed secondary breast cancer after an initial breast cancer diagnosis. That would help us to understand which populations see a recurrence of breast cancer and why, which treatments both sets of patients are accessing, what is working, which patients could try new treatments and whether both types of patients are getting the support that they need to cope with their diagnosis. Without knowing how many secondary breast cancer patients Scotland really has, how can the Scottish Government recruit enough specialists or properly workforce plan for tailored cancer services and support? Could screening and preventative health measures have reduced the risk?

I acknowledge that the debate is focused on supporting people living with secondary breast cancer but, predictably, I turn my thoughts to what we can do more of before that diagnosis. Artificial intelligence is transforming breast cancer imaging across multiple modalities, such as mammography, ultrasound, MRI and tomosynthesis. Recent studies show that AI can match—or, dare I say, outperform—radiologists in image reporting, which helps to reduce human error. However, its strength lies in amplification—doing more—and not in automation. AI gives health professionals more time with their patients and allows them to offer more personalised care and better patient choices. We need to invest in healthcare technology in Scotland’s NHS to make that the standard and give our NHS professionals the tools that they need to make a difference.

Alongside screening sits prevention. The European prospective investigation into cancer and nutrition—EPIC-Europe—which is co-funded by Cancer Research UK, is one of the biggest studies into the links between diet, lifestyle and cancer. Thirteen years ago, it found that those who were most physically active were 13 per cent less likely to develop breast cancer and that those who were moderately active had an 8 per cent lower chance of developing breast cancer. It is thought that physical activity may lower certain hormones and inflammation, helping to reduce the risk of breast cancer developing or progressing. We knew that 13 years ago but, according to the latest Scottish health survey, in 2024, only six in 10 adults in Scotland met the recommended levels of physical activity. The data has not significantly moved since 2012. Thirteen years ago, Sara Hiom, director of information at Cancer Research UK, said that we would be pleased to hear that

“You don’t have to train like an Olympic athlete”.

I am pleased to hear that. Exercise can include anything that leaves us slightly out of breath, such as doing the garden, walking the dog or housework. That is the whole point, but somehow that message is not getting to the communities that it needs to reach, and it is that lack of awareness that we need to address.