One stop breast clinics best for women

British Journal of Cancer

High-quality one-stop breast clinics could be the most effective way to spot breast cancer early, a study published in the British Journal of Cancer* reveals today (Wednesday).

Women going to their GP with symptoms that could be a sign of breast cancer are either referred to a one-stop clinic or to a breast unit at a hospital**.

For the first time, scientists have calculated that nearly all women who actually have breast cancer are correctly diagnosed on their first visit to a one-stop clinic.

At a one-stop clinic, women have physical breast examinations, scans and biopsies in one day. In other clinics, these tests happen at the hospital on separate days usually over the space of a week.

Experts believe that these clinics will not only help to meet the government's target of a maximum two-week wait between referral from a GP and diagnosis for all women with breast cancer symptoms***, but that eventually all women will have all three diagnostic tests performed in this time too, helping to reduce the anxiety associated with waiting for the results of breast cancer tests.

Dr Peter Britton, lead author based at Addenbrooke's Hospital in Cambridge, said: "Finding a lump or any other breast cancer symptom can be very worrying for a woman, so it's crucial that she receives her results as quickly as possible and knows that the result is reliable.

"We think these clinics are so successful because women are seen by a team of experienced specialists and their results are discussed by all of the team.

"In other clinics, only the results of women with cancer may be discussed. So debates over the diagnosis don't happen.

"This is the first time we've calculated how effective one-stop clinics are, and the accuracy of the tests is very encouraging.

"Unfortunately, it's practically impossible to create a system that spots every case of cancer - we don't yet have the technology to create a flawless test."

This study looked at 7,004 women discharged from a one-stop breast clinic without a diagnosis of cancer and followed them up for three years.

Doctors at the one-stop clinic missed 1.7 cancers in every thousand women. This rate is thought to be the lowest.

Twenty nine patients were diagnosed with breast cancer within the three year period.

Almost 60 per cent of these cancers were 'new' and not overlooked at the clinic. Nine cases were missed.

Sara Hiom, director of health information at Cancer Research UK, said: "Research into ways to spot cancer early is crucial - especially for cancers such as breast cancer where treatment is much more likely to be successful when diagnosed early.

"This is the first indication that one-stop clinics could be the best way to help reduce waiting times and improve diagnosis."

ENDS

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References

Britton, P., Duffy, S., Sinnatamby, R., Wallis, M., Barter, S., Gaskarth, M., O'Neill, A., Caldas, C., Brenton, J., Forouhi, P., & Wishart, G. (2009). One-stop diagnostic breast clinics: how often are breast cancers missed? British Journal of Cancer, 100 (12), 1873-1878 DOI: 10.1038/sj.bjc.6605082

Notes to Editor

* One-stop diagnostic breast clinics: how often are breast cancers missed? British Journal of Cancer. June 2009.

** Women will be referred to a one-stop clinic if there is one in their area.

*** At the moment, all 'urgent' cases are referred and diagnosed within two weeks. The Government aims to see all women with breast cancer symptoms in this time by December 2009.

This study looked at a single one-stop clinic at Addenbrooke's Hospital. The researchers were able to do this study, where most other units would have difficulty, because of a comprehensive patient database the "Joint Clinic Information System" (JCIS) which was funded by Cancer Research UK and the National Institute for Health Research.

The missed rate for breast units at a hospital is unknown. The missed rate for breast cancer screening is estimated to be 1.6 in every thousand women.

Around 93 per cent of women sent to one-stop clinics with symptoms don't have cancer.