UK guidelines and the National Cancer Plan explained

The short version

  • Breast cancer care in the UK is guided by NICE guidelines, national activity guidelines, and England’s National Cancer Plan.
  • NICE NG101 covers the diagnosis and management of early and locally advanced breast cancer.1
  • England’s National Cancer Plan (February 2026) promises a Personalised Cancer Plan for every patient and makes prehab and rehab core parts of care.2, 3

NICE guidance

GuidanceWhat it covers
NG101: Early and locally advanced breast cancerDiagnosis, surgery, radiotherapy, drug treatments, menopausal symptoms and follow-up.1
HTG719 (formerly DG34): Tumour profiling testsWhen tests such as Oncotype DX should be used to guide decisions about chemotherapy.4
TA886: OlaparibA targeted drug for some people with BRCA gene changes and high-risk early breast cancer.5
MTG70: SleepioRecommends Sleepio, a digital CBT programme, for insomnia.6

NICE guidance applies in England, and is often used in Wales and Northern Ireland. Scotland has its own processes.

Physical activity guidelines

The UK Chief Medical Officers’ guidelines recommend that adults aim for 150 minutes of moderate activity a week, and strength activities on at least 2 days a week.7 International guidelines for people with cancer recommend similar amounts.8

Radiotherapy

The Royal College of Radiologists recommends 26 Gy in 5 treatments over 1 week as the standard for radiotherapy to the whole breast or chest wall.9

Prehabilitation

UK guidance from Macmillan, the Royal College of Anaesthetists and the NIHR Cancer and Nutrition Collaboration recommends prehabilitation covering physical activity, nutrition and psychological support.10

England’s National Cancer Plan (2026)

The National Cancer Plan for England, published in February 2026, includes:2, 3, 11

  • a Personalised Cancer Plan for every patient, looking beyond treatment to wellbeing, nutrition, fatigue and work
  • an end of treatment summary explaining warning signs and who to contact
  • prehabilitation and rehabilitation as core parts of cancer care, with national quality standards from 2027
  • plans viewable on the NHS App by 2028, and a named neighbourhood care lead for every patient by 2035

See your Personalised Cancer Plan explained.

Scotland, Wales and Northern Ireland

Each nation has its own cancer plans and services. Examples include Prehabilitation for Scotland,12 Prehab2Rehab in Cardiff and Vale,13 and Northern Ireland’s Cancer Prehabilitation Toolkit.14 See NHS prehab and rehab across the UK.

Related pages

Everyone’s treatment is different, so talk to your cancer team about what is right for you.

References

  1. National Institute for Health and Care Excellence. Early and locally advanced breast cancer: diagnosis and management (NG101). www.nice.org.uk/guidance/ng101
  2. Department of Health and Social Care. Every cancer patient to get individual support plan. February 2026. www.gov.uk/government/news/every-cancer-patient-to-get-individual-support-plan
  3. Department of Health and Social Care. National Cancer Plan for England. February 2026. Summary of prehabilitation commitments as reported by the Royal College of Anaesthetists and Centre for Perioperative Care. rcoa.ac.uk/news/rcoa-cpoc-respond-release-governments-national-cancer-plan
  4. National Institute for Health and Care Excellence. Tumour profiling tests to guide adjuvant chemotherapy decisions in early breast cancer (HTG719, formerly DG34). www.nice.org.uk/guidance/HTG719/chapter/1-recommendations
  5. National Institute for Health and Care Excellence. Olaparib for adjuvant treatment of BRCA mutation-positive HER2-negative high-risk early breast cancer after chemotherapy (TA886): information for the public. www.nice.org.uk/guidance/ta886/informationforpublic
  6. National Institute for Health and Care Excellence. Sleepio to treat insomnia and insomnia symptoms (MTG70). 2022. www.nice.org.uk/guidance/mtg70
  7. UK Chief Medical Officers. Physical activity guidelines for adults and older adults. 2019. www.gov.uk/government/publications/physical-activity-guidelines-adults-and-older-adults/physical-activity-for-adults-and-older-adults-19-and-over-text-of-the-infographic
  8. Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Medicine & Science in Sports & Exercise. 2019;51(11):2375–2390. doi.org/10.1249/MSS.0000000000002116
  9. Royal College of Radiologists. Breast cancer radiotherapy dose fractionation, fourth edition. www.rcr.ac.uk/media/br2aqgpd/03-breast-cancer-radiotherapy-dose-fractionation-fourth-edition.pdf
  10. Macmillan Cancer Support, Royal College of Anaesthetists and NIHR Cancer and Nutrition Collaboration. Principles and guidance for prehabilitation within the management and support of people with cancer. 2019, updated November 2020. www.macmillan.org.uk/healthcare-professionals/news-and-resources/guides/principles-and-guidance-for-prehabilitation
  11. Maggie’s. National Cancer Plan: what does it mean? www.maggies.org/about-us/blog/national-cancer-plan-what-does-it-mean/
  12. NHS Scotland. Prehabilitation for Scotland: Prehab and Me. www.prehab.nhs.scot/
  13. Public Health Wales. Evaluation of Prehab2Rehab (Cardiff and Vale University Health Board). September 2025. phw.nhs.wales/reports/evaluation-of-prehab2rehab/
  14. Macmillan Prehabilitation Clinical Project Managers NI and Northern Ireland Cancer Network. Cancer Prehabilitation Toolkit. nican.hscni.net/wp-content/uploads/2026/02/Regional-Cancer-Prehabilitation-Toolkit.pdf