breast cancer uk. Prevention saves lives IMPACT REPORT ANDACCOUNTS 2023/24 Breast Cancer UK Ltd Charity No. 11388661 Company No. 7348408 breast cancer uk. ABOUT BREAST CANCER UK Our charitable objectives Our guiding principles Impact Report / A word from the Chair and CEO OUR SCIENCE PROGRAMME 8-15 10-13 14-15 Breast Cancer UK'S Grant Funding Programme Breast Cancer Prevention Conference OUR EDUCATION PROGRAMME 16-19 Prevention hub and education content Plans for our educational programme 17-18 19 OUR ADVOCACY PROGRAMME 20-23 Advocacy and campaigning Collaboration Next Steps 21 22 22-23 OUR GENEROUS SUPPORTERS Regular Giving (The B Well Club) Community and Events Fundraising In Memory Gifts and Legacies Corporate Partnerships 24-28 25 26-27 28 FINANCIAL REVIEW 29-32 30 30-31 31-32 32 Principal funding sources Charitable Expenditure Reserves policy Results and closing position STRUCTURE GOVERNANCE AND MANAGEMENT 33-37 Structure Governance Staff Risk Management Statement of public benefit Statement of Trustees Responsibilities for the Year Ended 31 March 2024 Auditor's report FINANCIAL STATEMENTS 34 34 35 35 36 37 38-40 41-53 ABOUT BREAST CANCER UK Around 55,500 women and 370 men in the UK are diagnosed with breast cancer every year and it is predicted that l in 7 women will get breast cancer at some point in their lives. Yet, at least 30/0 of breast cancers are preventable. That means that around 17,000 cases of breast cancer could be prevented each year, saving countless lives, reducing suffering and reducing the cost to the N HS. We believe there are many opportunities to reduce breast cancer rates in the UK potentially saving millions of lives as a result. We give practical advice on how people can reduce their risk of getting breast cancer by making simple changes in their lives. A unique aspect of our work focuses on the role played by hormone disrupting chemicals in increasing the risk of breast cancer and we work with other organisations to make our voice heard on this issue. We also fund research that we believe could be a game-changer in the field of breast cancer prevention. Our mission is to prevent suffering caused by preventable breast cancers through funding research, supporting individual behavioural change and campaigning for effective public health and environmental protections. We believe our work can have a significant impact on helping women and men reduce their risk of developing breast cancer. BREAST CANCER RATES DOUBLED IN 50 YEARS +24/0 SINCE 1996 AWOMAN'S LIFETIME RISK OF BREAST CANCER IS 1 IN 7 56,000 women diagnosed with breast cancer every year (for UK women born after 1960} ++++++i 96/. of breast cancers appear in women over 40 56,000 Women diagnosed with breast cancer each year in the UK Breast cancer is the 400 othmon Men diagnosed with breast cancer each year in the UK cancer in the UK 30% of breast cancer cases can be prevented Women will develop breast cancer at some point in their lives. 17,000 Cases of breast cancer that could be prevented each year WE EDUCATE AND RAISE AWARENESS OF THE PREVENTABLE RISK FACTORS FOR BREAST CANCERAND PROVIDE PRACTICAL INFORMATION TO HELP PEOPLE REDUCE THEIR RISK OUR CHARITABLE OBJECTIVES WE CAMPAIGN FOR POLICIES THAT SUPPORT THE PREVENTION OF BREAST CANCER WE SUPPORT SCIENTIFIC RESEARCH THAT HELPS TO UNDERSTAND AND ADDRESS THE PREVENTABLE RISK FACTORS FOR BREAST CANCER OUR GUIDING PRINCIPLES: Breast Cancer UK believes prevention is possible: more can be done to prevent breast cancers by tackling lifestyle and environmental risk factors. We are evidence based: scientific evidence is at the heart of our work with sources clearly identified. We champion high environmental and ethical standards: partnering with companies and suppliers whose own ethical and environmental policies match these standards. We believe in the right to know.. we want to empower people by giving them the information they need about the preventable risk factors for breast cancer, so they can make informed choices. We believe in collaboration: we will actively identify, seek and establish collaborations with other stakeholders le.g. charities, think tanks, companies, government and scientific institutions) to ensure we are effective in delivering our goals. WELCOME TO OUR 2023/24 IMPACT REPORT A WORD FROM OUR CHAIRAND CEO We are delighted to share our Impact Report and Accounts for the financial year 2023/24. Our mission to make breast cancer prevention a reality is a great challenge that we believe can be achieved through directly appealing to and nurturing our supporters, collaborating with those who share our passion and determination and investing in high-quality research 2nd education. This year we took strides towards reaching this ambition by strengthening our visibility through an expansion of our science-backed content and personalised advice, striving to match the needs of our supporters. We saw demand swell for our prevention education as we empowered greater numbers of people to take prevention into their own hands with our prevention quiz. We reached a significant milestone this year in hosting our first Breast Cancer Prevention Conference, proudly partnering with Middlesex University. The conference ignited new conversations and debates between scientists and experts across the health and environmental prevention research sectors, exploring the evidence, the gaps in our understanding and the priorities to act upon. We strengthened our scientific grant programme with a steady investment in new research grants and through new funding opportunities to cultivate greater interest and diversify this important field of research. This year's achievements enabled us to edge closer to our strategic targets, to grow our scientific programme and investment, widen the impact of our education through significantly expanding access to our personalised prevention planners, empowering more people to make breast cancer prevention a part of their lives. Our charity is entirely dependent on the generous donations of people, businesses, groups, clubs, schools, trust & foundations and associations who believe in and Want to support our work. Our achievements would not have happened without their support. This year our growing number of supporters helped our charity sustain financial growth for the third year running enabling greater investments in our science and education. For this, we want to express our deepest gratitude and appreciation. We wholeheartedly thank all of our valued supporters. Our engaged Board of Trustees oversaw the governance of our team and represented our charity with passion and commitment bringing a rich mix of skills and experiences. We were delighted to welcome Beezy Marsh who is an author 2nd journ21ist, N2Zi2 Tingay who is a Senior Payments Project Manager, Lotte Spencer who is a Marketing Director and Silvy Mardiguian who is Head of Economics and Outcomes Research. We were sad to say goodbye to Dr Britta Stordal, our Deputy Chair and Chair of our Science and Public Affairs Committee. Britta's investment in the charity and her skills, insights and passion have brought significant value to our cause. We thank her for her commitment. We also said goodbye to Nichole Taske, who also served on our Science and Public Affairs Committee bringing invaluable public health policy knowledge to the charity. We thank Nichole for her commitment. Finally, we farewelled Charlie Winstanley who also served on our Science and Public Affairs Committee, bringing a breadth of policy and public health knowledge. We thank him for his commitment. Our passionate and talented team continued to expand to meet the swell in demand for our work. With this growth comes a greater mix of skills, backgrounds and experience enriching the work that we do. The team's tireless commitment to achieving impact is hugely appreciated. Their feedback has told us that they love working together to achieve one goal and that they feel their contribution is making a difference. We thank all of our colleagues for their commitment and dedication. This year has shown that we can achieve our ambition and strive for more. As we enter the last year of our strategic plan we remain steadfast in our commitment to put breast cancer prevention at the core of the public health and environmental responses to this devasting disease. We look forward to continuing to stride forward with our supporters and partners to make preventing this disease a priority. Ruth Freeborough Chair, Breast Cancer UK Thalie Martini CEO, Breast Cancer UK OUR SCIENCE PROGRAMME Our objectives were to; Support high-quality, independent scientific research projects at universities or research institutes within the UK. Bring relevant, high-quality data and new research findings into the public arena Grow our scientific expertise and reputation in the field of breast cancer prevention A key mission of ours is to understand the preventable causes of breast cancer so that we can translate this into practical measures that help reduce the impact of breast cancer on people's lives. Our science programme is dedicated to exploring the link between breast cancer and potentially harmful chemicals found in everyday products and in our environment. We have made this our focus as we believe that there is an urgent need to build greater evidence around the harms these chemicals may be causing to our health and our breast cancer risk. While there is convincing evidence to show that lifestyle factors such as alcohol consumption and obesity can influence breast cancer risk, there is less wide- ranging evidence available on the effects of environmental chemicals and possible links with breast cancer. Our grants programme aims to help fill the gap in our knowledge and understanding of this complex area of breast cancer risk. BREAST CANCER UK'S GRANT FUNDING PROGRAMME RESEARCH PROJECTS Completed projects Brunel University London Examining how Endocrine Disrupting Chemicals {EDCs) mixtures and a high-fat diet affect breast cancer Dr Elisabete Silva, Brunel University The project examined the impact of mixtures of Endocrine Disrupting Chemicals {EDC5) and saturated fats (that may result from a high fat diet) on early stages of breast cancer. Findings from this project showed that 3D spheroids of normal breast cells exposed to a mixture of Endocrine Disrupting Chemicals (EDCS) 2nd saturated fats resulted in a more deformed structure compared to non-exposed cells. This project also validated an exciting new three-dimensional breast cancer model system known 25 "Breast-on-chip" This model contained three prominent cell types found in the breast and more closely resembled how breast cells behave in the body. The model will make future experiments involving mixtures of Endocrine Disrupting Chemica15 IEDCs)/saturated fats more human-relevant. UNIVERSITY Current Projects .fHULL Investigating effects of per- and poly-fluoroalkyl (PFAS, or per- and polyfluoroalkyl substances) substances on breast cancer development February 2024 - Present This PhD studentship project was awarded to Dr Mark Wade and PhD student Ms Lucie Bilton of the University of Hull. This project aims to investigate whether PFAS, or per- and polyfluoroalkyl substances ("forever chemicals") play a role in breast cancer development and determine whether microplastlCS that can leach PFAS, or per- and polyfluoroalkyl substances are found in breast tissue. Normal breast cells will be exposed to PFAS, or per- and polyfluoroalkyl substances at levels found in the blood and then be assessed for characteristics often found in cancerous cells. The effect of long and short-term exposure will be an21ysed to see what changes occur immediately and which develop over time. Breast tissue from patients will also be analysed for microplastics. 10 College LONDON Measurement of Endocrine Disrupting Chemicals (EDCS) in breast cancer November 2023- Present This 18-month project was awarded to Dr Michael Antoniou with Research Assistant, Charlotte O'Hern, at King's College London. This project aims to assess the potential risks arising from Endocrine Disrupting Chemicals (EDCS) found in everyday products that can potentially lead to or promote breast cancer. Frozen breast cancer samples will be screened for oestrogen-like chemical pollutants. Cancer and non-cancerous fatty tissue from the same breast will be analysed. The results will be used to assess if there is a connection between the amount and type of oestrogen-like chemical pollutants detected and breast cancer growth and spread. IWI UNIVERSITY OF ABERDEEN Evaluating the effects of BPA on breast cancer development February 2023 - Present This PhD studentship project was awarded to Prof Val Speirs and her PhD student Ms Katharin2 Kusserow at the University of Aberdeen. This project is investigating the effect of bisphenol A {BPA) on the non-cancerous breast and how it may contribute to breast cancer development. The project will involve a systematic review of existing literature to assess the current understanding of how BPA affects breast tissue and computer-based 2ppr02ches to identify genes related to BPA exposure. Laboratory experiments will then assess any potential involvement of those selected genes in breast cancer development. BPA levels will also be measured in blood samples donated by breast cancer patients. College LONDON Biomonitoring 2nd molecular toxicity profiling of bisphenol mixtures February 2022 - Present This PhD studentship was awarded to Dr Michael Antoniou and his PhD student Connor Powell at King's College London. This research project aims to complete a biomonitoring study where urine samples are collected from the general public and analysed for bisphenol compounds to help determine the levels of bisphenol exposure in the UK population. 11 Publications Di Pasquale A. Endocrine Disrupting Chemicals: the role they play in breast cancer. Open Access Government. 2024. https://www.openaccessgovernment.org/endocrine-disrupting-chemicals-the- role-they-play-in-breast-cancer/1749631 Powell C, Mesnage R, Antoniou MN, Vandenberg LN. Low dose effects of environmental chemicals: Bisphenol A as a case study. Encyclopedia of Toxicology, Fourth Edition: Volume 1-9 2024.5.955-67 https://doi.org/lO.1016/B978-0-12- 824315-2.00762-4 A NEW STRUCTURE FOR OUR GRANT APPLICATION ROUND 2023/24 Our most recent funding round called for applications that focus on the relationship between Endocrine Disrupting Chemicals {EDCs) and breast cancer risk" this was launched in November 2023 and closed in February 2024. For this funding round, we developed a new funding structure. This year two separate grants were available, known as our Foundation Award and Seed Award. Our Foundation Award supports anchoring new principal investigators in the research area of breast cancer prevention. Applications were asked to focus on Endocrine Disrupting Chemicals {EDCs) (known or suspected) and breast cancer risk. The Award will fund up to £150,000. primary applicants should be within 12 years of their PhD being awarded. Alongside the proposed funding for research, Breast Cancer UK also offered an optional career coaching programme for the duration of the grant to help support and develop the wider skills of the early career scientist. Our Seed Award is focused on chemicals and breast cancer risk. Funding can be applied flexibly and may be utilised as a top-up for a project close to completion, to nht2jn 2 cnprifir njprp nf pni ijnmpntr nr tn fi inA 2 njlnt nrniprt fnri i "Lovp thls.- Really iTrked the prev8ntlon plarL_ Very helpful and important for me and ralsing my two tiny hurnar￿, 5kof owt(y*ps Chooso preventio C￿rinthe1utU1¢. E¥￿ry￿e hassome riskofgetNngt*e3St te*th￿aN 19 OUR ADVOCACY PROGRAMME Our objectives for the last year were to: Encourage a preventative approach by campaigning to improve legislation and public he21th policy which helps to promote the primary prevention of breast cancer. Work at UK levels for policy and regulatory changes that help to protect against breast cancer. Raise the profile of our key messages amongst political decision makers by establishing a network of activists to help us make our message heard. OUR CAMPAIGNING Our campaigning objectives remained consistent into our 23/24 year with a main focus on. Promoting preventative approaches to breast cancer and more broadly prevention being put at the centre of healthcare policy. Work to bring about policy changes at all levels of government that promote a preventative approach in health policy. Principally, the scrapping of the proposed Major Conditions Strategy and the return of a standalone Cancer Strategy. Advocate for a precautionary principle approach in chemicals regulation and the publication of a Chemicals Strategy. We put our case to top officials in the Department for Environment Food and Rural Affairs. In collaboration with other organisations, we advocated to the Government to keep high regulatory standards and not diverge from the European Union's established regulatory system and EU REACH. In preparation for the expected general election, we reached out to those in opposition and identified key alignments in our policy priorities on cancer prevention. We were proud to produce our first Manifesto for Breast Cancer Prevention, merging our scientific knowledge with our policy expertise on breast cancer prevention into a single document. Work on this began in the period covered by this report. ADVOCACY ANDCAMPAIGNING This year we led on a number of consultation submissions including on the Regulatory Management Options Analysis for bisphenols where we highlighted the need for a greater focus on the cocktail effect on human health through exposure to multiple chemicals in our daily lives. While we continued to point out to the Government th2t the UK is falling well behind European countries such as Germany who continue to pursue more stringent restrictions on the use and distribution of bisphenols, it was frustratingly clear that the then Government was not persuaded on the urgency to address either point. 21 Given the limited progress with the Government's regulatory and policy developments on chemical exposures, thanks to the support of the Savitri Trustee, we collaborated with our partners in the NGO working group on hazardous chemica15 to develop a bespoke public awareness campaign on the impact of harmful chemicals on our health including on our breast cancer risk. This work will feed into Breast Cancer UK'S mobilisation campaign. We continued to develop constructive relationships with the Department for Environment Food and Rural Affairs (Defra) and the Department for Health and Social Care (DHSC). We also engaged directly with Dr Philippa Whitford, then MP and breast cancer surgeon and the then MP for Hitchin and Harpenden, Bim Afolami who provided a message of support at our breast cancer prevention conference and also supported our cause by sharing our quiz with his constituents. Additionally, we wrote to. Victoria Atkins MP (then Secretary of State for Health and Social Care) Rishi Sunak MP (the Prime Minister) Steve Barclay (then Secretary of State for Health and Social Care} Rebecca Pow (then Parliamentary Under-secretary of State at the Department for Environment, Food and Rural Affairs, with responsibility for chemicals policy) COLLABORATION Our size as an organisation, the complexity of the policy areas that we work within 2nd the difficult politlC21 landscape that characterised this period made collaboration an absolutely crucial part of our work. We continue to be a driving force behind the NGO working group for hazardous chemicals which brings together several organisations with interests in chemical regulation. A sub-group was formed from this, the 'Health sub-committee,, which looks specifically at the human health implications of exposure to harmful chemicals. In addition, we have strong links with the EDC-Free Europe coalition and the European Movement with whom we share information and ideas around alignment with EU REACH (the European Regulatory System for Chemicals). We have also continued to build alliances with organisations with whom we share policy priorities including CH EMTrust, Animal Free Research, the Women's Environmental Network, the Wildlife and Countryside Links and the Alcohol Health Alliance. NEXT STEPS Our priority looking ahead is to launch our manifesto alongside the general election, giving us a basis from which to influence policy development on breast cancer prevention. We will target key MPS, Peers and policy-makers who we believe should be engaging with our work. 22 We will continue to nurture our existing partnerships and recognise that these are vital in making sure that we are around the table for key policy discussions. However, we also recognise that there are other organisations, particularly health charities, who may be campaigning for similar outcomes to ourselves, such as improving the public's eating, drinking or buying habits and we will be actively looking to partner with those organisations. As we come towards the end of the existing Public Affairs Strategy, we will embark on new planning work to set out a robust 3-year plan for our advocacy and campaigning work in the years ahead. We will be looking to build a plan that engages more closely with our supporters, empowering them to help drive the change needed to make breast cancer prevention a policy priority. ca EST EAST CANCER PREVENTION 23 OUR GENEROUS SUPPORTERS This was a year of continued growth for our fundraising team. A year in which we set the foundations for our long-term ambitions. An ambition to take our income from just over £IM to over £4M within the next 5 years. Backed by an army of committed supporters who are joining our mission to put prevention at the top of the breast cancer debate. We thank them all for their invaluable support. REGULAR GIVING (THE B WELL CLUB) We developed and launched our new monthly regular giving offer - The B Well Club. Each month we send our wonderful members fun and practical wellness advice backed by science. We have curated recipes, exercises, healthy habits and much more to help people make small changes to their daily lives to improve their overall health and reduce their breast cancer risk. reas cancer uk. •J Hello, <>l It's time to spring into life .1 Celthathys a￿ in tyder! We've rtwde it thr¢W￿ the LMg, dark i*)s of wirter, aTrJ iv5 finally to Eet cth5th and eftioy tevry at ￿le V+ith nature. If ￿'ve shbed away frcln riding y￿r th.ke or golng on Yfti&s tecause Gf you're Tr)t alore. &Jt wth the 5WJ s40￿Y starting to retLYn, it's rErfect t7￿ to get back out tse aEain. Sprfne ts a seawi of ¥tfvatSrn, w￿ther St's eatlng tetter, maklng for exercF5e, ftmdraisir¢> or tyi"nE yow hand at that thing you've putting off a ￿lIe, hit the activate buttcn! P.S. FIcv*JEf5 arn't the thi￿ tl4t ￿ 5prv)g into life th15 seas(￿. 25 COMMUNITY AND EVENTS FUNDRAISING People fundraising for us has long been the bedrock of our fundraising programme and we're so grateful and thankful for their fantastic ongoing support. This year 622 people ran event5 for us raising £480,504.84 an average of £772 per fundraiser. Alongside this several supporters took part in organised events to support our work this included: Battle Cancer: We had 42 participants who raised £22,092.24 Kilt walk: We had 44 participants who raised £14,388.75 Skydiving: We had 24 participants who raised £33,990.49. HERE'S SOME HIGHLIGHTS FROM OUR WONDERFUL FUNDRAISERS: Thank you to Ivan Mond, a 90-year-old skydiver and his family who raised £8,576. We ensured they had impactful media coverage during April 2023 here. Thank you to Ashley and Oliver from Northamptonshire who trekked to Everest Base Camp in August 2023, before attempting to climb and summit a nearby peak - Imja Tse16,160m, 20,200 ft). They raised £5,916.63 h Thank you to brothers Alex and Olly from Derbyshire who took part in the Peak District Ultra Marathon at the start of October 2023 as their mum had recently been diagnosed with breast cancer, they raised £7,187 here. Thank you to James Roden and his colleagues from the RAF Lechlade who took part in a pedalo challenge along the Thames in July 2023 and raised £14,041.26 here. Thank you to Jessica Allan from the West Midlands and her sister Emma who organised a 20-mile sponsored walk at the end of March 2023 to mark 20 years since their mum Helen Brayn passed away, they raised £5,088.75 including gift aid on JustGiving here. We thank Karen Whitehead who, in June 2023, shaved her head in solidarity with a friend who is currently going through breast cancer, raising £7,196 here. Thank you to Nick White and his team TMAAT (Three Men and a Tent) who raised £6,283 as they took part in a cycling challenge from London to Athens in May and June 2023 h We thank Peter Mackenzie from Cheshire who, in August 2023, took on his second challenge for Breast Cancer UK. He played 250 holes of golf in 24 hours and raised £12,712.15 here. Thank you to James Saunderson and 5 teams from The Unit Gym and Fitness who took part in Battle Cancer Scotland in June 2023. James's wife Hazel was being treated for Breast cancer. The group raised £15,052.78 here. 26 Thank you to Gavin O'Rourke from London who took part in the London Marathon in April 2023, his wife has previously had breast cancer. He raised £5,012.13 here. Thank you to Hannah Blaber and friends from Knowle Tennis Club in Bristol who held a 12-hour Tennis Marathon in May 2023 in memory of their friend Malgo. They raised £5,500.471 Breast¥ ' 27 PHILANTHROPIC GIVING We are hugely grateful to those supporters who generously pledged their gifts through Wills and donated in memory of a loved one. These gifts have enabled us to make significant investments in our scientific research and our education programmes both of which have grown thanks to the highly valuable support of these donors. Our two largest legacy gifts were from Mr Deryck Anthony Nott and from Mrs Jean Mary Hastings. We plan to continue to nurture and develop rewarding relationships with donors whose dedication to our mission and our cause is key to strengthening and growing our impact. We wholeheartedly thank all of our valuable donors for choosing to support our charity. We were extremely thankful to receive a number of other large in memory gifts from Mary Edkins, Amanda Symes and Ailsa Thomas. CORPORATE PARTNERSHIPS We were supported by a wide range of wonderful businesses and their great teams who do amazing things for us, from putting on golf days, throwing themselves out of plane5, to donating a percentage of profits from the sale of products. We want to thank all of the businesses and organisations who generously supported us this year. Some highlights: fljmhpr< A92jn