RT Journal Article
SR Electronic
T1 Community breast pain clinics can provide safe, quality care for women presenting with breast pain
JF BMJ Open Quality
JO BMJ Open Qual
FD British Medical Journal Publishing Group
SP e002882
DO 10.1136/bmjoq-2024-002882
VO 13
IS 4
A1 Sibbering, Mark
A1 Rogers, Veronica
A1 Merriman, Louise
A1 Azmy, Iman
A1 Stafford, Denise
A1 Clifton, Kevin
A1 Pickard, Jennifer
A1 Bartholomeuz, Thilan
A1 Robertson, John
YR 2024
UL http://bmjopenquality.bmj.com/content/13/4/e002882.abstract
AB Introduction Breast pain is not typically a symptom of breast cancer, yet nationally 20% of 2-week wait (2WW) breast referrals are breast pain alone. The East Midlands Breast Pain Pathway improves patient experience and frees capacity in secondary care diagnostic breast clinics, managing women with breast pain only in a community setting. We report the results of implementation of community breast pain clinics (CBPCs) at sites in Derbyshire (catchment population ~1 million), with 12 months follow-up data.Results 1036 patients were seen at CBPCs between June 2021 and February 2023. The median patient age was 49 (range 16–88) years. 993 patients (95.8%) were discharged from the clinic with breast pain management advice. 43 (4.2%) patients were referred for further assessment at a 2WW breast diagnostic clinic. Objective family history risk assessment identified 124 patients (12.3%) above population risk of breast cancer, who were offered referral to familial cancer services for ongoing management.Discussion Seven patients were diagnosed with breast cancer at or within 12 months of CBPC attendance. Five patients were diagnosed through attending the CBPC, one patient was subsequently referred to 2WW clinic with a new symptom and had a mammographically occult tumour and one was diagnosed following a subsequent routine breast screening invitation. Two of the five patients had a personal history of breast cancer which was a stated exclusion criterion for the CBPC. Breast cancer incidence in women with breast pain only and fulfilling CBPC referral criteria was 4.8/1000, confirming that this population is at low risk of developing breast cancer.Patient service satisfaction was high with 99% (n=1022) ‘extremely likely or likely’ to recommend the service.Conclusion The results confirm the pathway is the first to demonstrate women can be safely managed with breast pain alone in a community setting with high levels of patient satisfaction.All data relevant to the study are included in the article or uploaded as online supplemental information. Not Applicable.