One third of all referrals to find 1% with cancer: a cross-sectional study of clinical presentation in women under 40 referred to a UK breast clinic
Association of Breast Surgery ePoster Library. Savioli F. 05/13/19; 257122; P078
Ms. Francesca Savioli
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P078
Topic: Diagnosis/ Referral
AimBreast cancer is uncommon in women under 40.1We aimed to evaluate referrals to the Breast clinic; investigations; and subsequent diagnoses, in order to allocate clinic resources appropriately for this group.MethodFemale patients referred to an NHS breast clinic (300,000 population) reviewed over six months (1st July to 31st December 2017).Of 1311 referrals, 444 (34%) were under 40.41 excluded (21 DNA; 3 redirected; 17 incomplete): study population 403. Results: 172 (43%) women were referred urgently (Scottish ‘2 week wait'); 18 (4%) ‘soon'; 213 (53%) routinely. Median age 32 (range 14-39).Women referred urgently were significantly older than those referred routinely (median age 33 vs 30: Mann Whitney P<0.0002).22 (5%) were pregnant or within one year following pregnancy.289 (72%) had normal findings clinically or on imaging. 110 (27%) were given a benign diagnosis.There was no re-presentation with malignancy from the study population in the 11-16 months elapsed since.248 (61%) had breast ultrasound; 61 (15%) had core biopsy. Only 24 (6%) had mammography, in line with local policy to avoid without specific indication.Four malignancies (<1%) were found: 2 invasive ductal cancer (ages 28 and 32); 1 DCIS (38); and 1 malignant Phyllodes (39).ConclusionWomen under 40 comprised one third of referrals, though the vast majority (99%) received a normal or benign diagnosis. No ‘missed' cancers have been identified to date. This may be of use in allocating clinic resources, and should be reassuring to those awaiting assessment.1. Cancer Research UK, 2013-2015.
Topic: Diagnosis/ Referral
AimBreast cancer is uncommon in women under 40.1We aimed to evaluate referrals to the Breast clinic; investigations; and subsequent diagnoses, in order to allocate clinic resources appropriately for this group.MethodFemale patients referred to an NHS breast clinic (300,000 population) reviewed over six months (1st July to 31st December 2017).Of 1311 referrals, 444 (34%) were under 40.41 excluded (21 DNA; 3 redirected; 17 incomplete): study population 403. Results: 172 (43%) women were referred urgently (Scottish ‘2 week wait'); 18 (4%) ‘soon'; 213 (53%) routinely. Median age 32 (range 14-39).Women referred urgently were significantly older than those referred routinely (median age 33 vs 30: Mann Whitney P<0.0002).22 (5%) were pregnant or within one year following pregnancy.289 (72%) had normal findings clinically or on imaging. 110 (27%) were given a benign diagnosis.There was no re-presentation with malignancy from the study population in the 11-16 months elapsed since.248 (61%) had breast ultrasound; 61 (15%) had core biopsy. Only 24 (6%) had mammography, in line with local policy to avoid without specific indication.Four malignancies (<1%) were found: 2 invasive ductal cancer (ages 28 and 32); 1 DCIS (38); and 1 malignant Phyllodes (39).ConclusionWomen under 40 comprised one third of referrals, though the vast majority (99%) received a normal or benign diagnosis. No ‘missed' cancers have been identified to date. This may be of use in allocating clinic resources, and should be reassuring to those awaiting assessment.1. Cancer Research UK, 2013-2015.
P078
Topic: Diagnosis/ Referral
AimBreast cancer is uncommon in women under 40.1We aimed to evaluate referrals to the Breast clinic; investigations; and subsequent diagnoses, in order to allocate clinic resources appropriately for this group.MethodFemale patients referred to an NHS breast clinic (300,000 population) reviewed over six months (1st July to 31st December 2017).Of 1311 referrals, 444 (34%) were under 40.41 excluded (21 DNA; 3 redirected; 17 incomplete): study population 403. Results: 172 (43%) women were referred urgently (Scottish ‘2 week wait'); 18 (4%) ‘soon'; 213 (53%) routinely. Median age 32 (range 14-39).Women referred urgently were significantly older than those referred routinely (median age 33 vs 30: Mann Whitney P<0.0002).22 (5%) were pregnant or within one year following pregnancy.289 (72%) had normal findings clinically or on imaging. 110 (27%) were given a benign diagnosis.There was no re-presentation with malignancy from the study population in the 11-16 months elapsed since.248 (61%) had breast ultrasound; 61 (15%) had core biopsy. Only 24 (6%) had mammography, in line with local policy to avoid without specific indication.Four malignancies (<1%) were found: 2 invasive ductal cancer (ages 28 and 32); 1 DCIS (38); and 1 malignant Phyllodes (39).ConclusionWomen under 40 comprised one third of referrals, though the vast majority (99%) received a normal or benign diagnosis. No ‘missed' cancers have been identified to date. This may be of use in allocating clinic resources, and should be reassuring to those awaiting assessment.1. Cancer Research UK, 2013-2015.
Topic: Diagnosis/ Referral
AimBreast cancer is uncommon in women under 40.1We aimed to evaluate referrals to the Breast clinic; investigations; and subsequent diagnoses, in order to allocate clinic resources appropriately for this group.MethodFemale patients referred to an NHS breast clinic (300,000 population) reviewed over six months (1st July to 31st December 2017).Of 1311 referrals, 444 (34%) were under 40.41 excluded (21 DNA; 3 redirected; 17 incomplete): study population 403. Results: 172 (43%) women were referred urgently (Scottish ‘2 week wait'); 18 (4%) ‘soon'; 213 (53%) routinely. Median age 32 (range 14-39).Women referred urgently were significantly older than those referred routinely (median age 33 vs 30: Mann Whitney P<0.0002).22 (5%) were pregnant or within one year following pregnancy.289 (72%) had normal findings clinically or on imaging. 110 (27%) were given a benign diagnosis.There was no re-presentation with malignancy from the study population in the 11-16 months elapsed since.248 (61%) had breast ultrasound; 61 (15%) had core biopsy. Only 24 (6%) had mammography, in line with local policy to avoid without specific indication.Four malignancies (<1%) were found: 2 invasive ductal cancer (ages 28 and 32); 1 DCIS (38); and 1 malignant Phyllodes (39).ConclusionWomen under 40 comprised one third of referrals, though the vast majority (99%) received a normal or benign diagnosis. No ‘missed' cancers have been identified to date. This may be of use in allocating clinic resources, and should be reassuring to those awaiting assessment.1. Cancer Research UK, 2013-2015.
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