Evaluating breast cancer surgery ascertainment in England's routine healthcare data: A retrospective cohort…

Cohort studyCancer epidemiology· Jul 2026

Evaluating breast cancer surgery ascertainment in England's routine healthcare data: A retrospective cohort study.

Liyang Wang, Diana Withrow, Christine Delon … David Cromwell

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Breast SurgeryCohort studyClinical practiceQ2IF 3.1

Cancer Treatments dataset agreement with Hospital Episode Statistics for breast surgery type was 94.0%.

Evaluating breast cancer surgery ascertainment in England's routine healthcare data: A retrospective cohort study.

Liyang Wang … David Cromwell

Cancer epidemiology · Jul 2026

Background

Real world evidence is increasingly used in population-level breast cancer research, but the validity of procedure recording across routinely collected healthcare datasets in England remains uncertain.

Methods

This retrospective study included patients diagnosed with breast cancer in England between 01/01/2015 and 31/12/2023, identified from the National Cancer Registration Dataset.

n = 421,949 patients

Results

type of surgery matched between the two records in most patients

92.6%

Sensitivity

98.9%

Specificity

More results

Among 421,949 patients, 337,622 (80.0%) had surgery recorded in the Cancer Treatments dataset and 327,242 (77.6%) in Hospital Episode Statistics.

In 224,418 patients with breast-conserving surgery in both datasets, agreement for reoperation within 12 months was 97.9% (kappa 0.92), with sensitivity 92.6% and specificity 98.9%.

More results

However, there was minimal capture of oncoplastic breast-conserving surgery and immediate breast reconstructions in the Cancer Treatments dataset.

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Conclusion

The Cancer Treatments dataset provides robust ascertainment of breast cancer surgery, specifically breast-conserving surgery, mastectomy and re-operation after breast-conserving surgery, but is less reliable for detailed operative information, including oncoplastic breast-conserving surgery procedures and immediate breast reconstruction.

Evaluating breast cancer surgery ascertainment in England's routine healthcare data: A retrospective cohort study.

Evaluating breast cancer surgery ascertainment in England's routine healthcare data: A retrospective cohort study.

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