Audit of two week wait for breast cancer in Birmingham NHS Foundation Trust

Authors Avatar

Audit of two week wait for breast cancer in Birmingham NHS Foundation Trust

Introduction.

Breast cancer is the commonest malignancy to affect women with approximately 32,000 new cases per annum in England and Wales. The maximum 2-week wait for breast cancer referral was introduced by the UK Government on 1 April 1999 in an attempt to improve outcomes for patients with breast cancer. The resultant fast track or two week wait rule stipulated that all patients with suspected breast cancer should be seen by a specialist within two weeks of urgent referral by a general practitioner thus facilitating early diagnosis and treatment.

Criteria for urgent two week wait referral of patients with suspected breast cancer include:

  • Patients of any age with a discrete hard lumps with fixation, with or without skin tethering, females aged > 30 years with discrete lump persisting after period/menopause, males aged > 50 with a unilateral firm subareolar mass with or without nipple distortion or associated skin changes
  • Nipple changes – ulceration, skin nodule, skin distortion, nipple eczema, nipple retraction or distortion of recent onset (< 3 months)
  • Patients of any age with single duct or bloodstained nipple discharge, all women over 50 with nipple discharge.
Join now!

Following the 1999 implementation of the “two week wait” initiative for Breast Cancer, concerns have been expressed on the number of breast cancers which came through the routine referral route as some studies have suggested that almost a third of cancers in a referral population have not come through the rapid referral service.

Aims.

The aims of the audit were to analyse the performance of fast-track two week wait system for breast cancer in Birmingham NHS Foundation Trust, measure the compliance to the guidelines and evaluate the effectiveness of urgent referrals (cancer detection rates).

Methods.

...

This is a preview of the whole essay