Impact of Routine Expert Breast Pathology Consultation and Factors Predicting Discordant Diagnosis

Abstract

common to many breast centers, however, the utility of certified letters as an isolated intervention has not been previously metered or described. In our breast care center, a certified letter with signature upon delivery requirement is sent after a patient has missed their scheduled appointment. We evaluated the effect of a certified letter on follow up for high-risk patients and those with a history of breast cancer. METHODS:A retrospective review of a prospectively maintained database for patients at high lifetime risk for breast cancer (> 20% based on Tyrer-Cuzick score) or those with a personal history of breast cancer was conducted for January-May 2019. Patients who missed their scheduled appointment were mailed a certified letter, and subsequent follow up compliance was documented. RESULTS:Of 331 patients, 234 (70.7%) were independently compliant with their individual screening regimen. Missed clinic visits were noted for 97 (29.3%) patients, who were subsequently sent a certified letter. Breast cancer patients accounted for 54 (55.7%) of the 97 patients. Return to the breast center was observed in 68 (70.1%) of these patients, with an average of 67 days to follow up after letter reception.CONCLUSION: A certified letter is an effective means of encouraging patient follow up in a high-risk breast population.