P093. Rapid implementation of triaging system for assessment of breast referrals from primary care centres during the COVID-19 pandemic

Shetty, Geeta; Datta, Uttaran; Rea, Ian; Rai, Simerjit; Hwang, Mei-Ju; Hoar, Fiona; Sintler, Martin; Mirza, Mehboob; Husain, Asma; Tan, Melissa

doi:10.1016/j.ejso.2021.03.097

Cited by 1 publication

(4 citation statements)

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“…The referral rate fall is linked to several factors, including the GPs more stringent referral approach, health facility avoidance by patients prone to nosocomial infection, and government and media campaign against hospital visits. Our study shows an increased 2ww target and cancer diagnosis rate in the pandemic era, similar to previous findings [ 15 , 16 ]. The increased 2ww target is partly due to the diversion of facilities and clinicians to the one-stop clinic following the suspension of benign and reconstructive procedures and family history clinics.…”

Section: Discussionsupporting

confidence: 92%

“…The audit represents the experience of a single specialist breast center, and the results may not be generalizable to other centers. This study has not reported the number of missed cancers among the telephoned and discharged patients, as with previous studies [ 16 , 27 ]. This study has also not reported the presenting complaints and specific diagnosis data as they are not part of the study design.…”

Section: Discussionmentioning

confidence: 53%

“…There is no statistically significant difference in the wait time and cancer diagnosis rate between the telephone and one-stop clinic patients, suggesting that telephone consultation is not inferior to face-to-face consultation. Several studies have documented the effectiveness of telephone consultation within [ 16 ] and outside [ 19 , 20 ] the breast specialty, although the risk of missed cancers because of lack of clinical examination is always a concern. We observed a high post-telephone one-stop clinic follow-up, and the cancer detection rate of 9.0% of those seen face-to-face post-telephone consult in 2020 is equivalent to routine referral rates [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…It was also predicted that cancer mortality, including breast cancers, will worsen after the pandemic [ 8 , 10 ]. Some studies have shown a rebound in the 2ww referral [ 12 , 16 , 17 , 26 ] and breast cancer diagnosis rates [ 16 , 25 ] and predicted a shift in breast cancer diagnosis from early to advanced stages following the COVID-19 pandemic [ 18 , 25 ]. Several specialist breast services have implemented telephone consultations and virtual meetings during the COVID-19 pandemic [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

A Single-Center Audit of Symptomatic Breast Cancer Patient Referrals During COVID-19 Pandemic Restrictions

Tokode¹,

Rastall²

2022

Cureus

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Background Recommendations to balance cancer care with patient and hospital staff safety have been issued to hospitals during the coronavirus disease (COVID-19) pandemic. Concerns have been raised that service restrictions could jeopardize effective cancer management. Thus, this study aimed to conduct an audit to verify this proposition. Methods We conducted an audit comparing two-week wait (2ww) breast cancer referrals in our center between May and July 2019 and 2020. The primary endpoints were changes in the overall referral rates, differences in the waiting time, and breast cancer diagnosis rates between the two cohorts. Group differences were evaluated using the chi-square test (χ 2 ). A p-value of <0.05 at 95% CI was considered significant. Results The 2ww referrals decreased by 442 (28.3%) in 2020 (2019 N=1564 vs. 2020, N=1122). Referrals in 2020 were associated with a higher rate of two-week specialist consultation than referrals in 2019 (p<0.05). The 2020 patient cohort was associated with a higher rate of breast cancer diagnosis than the 2019 cohort (6.9% vs. 4.9%, p<0.05). Of the 521 patients who had telephone consultations, 29.2% were discharged, and 367 (70.4%) had post-telephone one-stop clinic visits, of which 9.0% had breast cancer. Conclusions The audit provided evidence of effective breast cancer services during the COVID-19 pandemic restrictions. The study results could inform patients and the general public at large that the waiting time and breast cancer diagnosis are not compromised during COVID-19 pandemic management. The high rates of post-telephone one-stop clinic visits and cancer diagnosis may indicate weakness in triage and difficulties in diagnosing nonspecific presentation of cancer over the telephone.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 53%