Community breast pain clinics can provide safe, quality care for women presenting with breast pain.

IF 1.3 Q4 HEALTH CARE SCIENCES & SERVICES BMJ Open Quality Pub Date : 2024-10-30 DOI:10.1136/bmjoq-2024-002882
Mark Sibbering, Veronica Rogers, Louise Merriman, Iman Azmy, Denise Stafford, Kevin Clifton, Jennifer Pickard, Thilan Bartholomeuz, John Robertson
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Abstract

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.

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社区乳房疼痛诊所可以为出现乳房疼痛的妇女提供安全、优质的护理。
简介乳房疼痛通常不是乳腺癌的症状,但在全国范围内,20%的两周等待(2WW)乳腺转诊患者仅为乳房疼痛。东米德兰乳房疼痛路径改善了患者的就医体验,释放了二级医疗机构乳房诊断诊所的能力,仅在社区环境中对患有乳房疼痛的妇女进行管理。我们报告了德比郡(覆盖人口约 100 万)社区乳痛门诊(CBPCs)的实施结果以及 12 个月的随访数据:2021 年 6 月至 2023 年 2 月期间,1036 名患者在 CBPC 就诊。患者年龄中位数为 49 岁(16-88 岁不等)。993名患者(95.8%)在接受乳房疼痛治疗建议后出院。43名患者(4.2%)被转诊至两维乳腺诊断诊所接受进一步评估。客观的家族史风险评估发现,有124名患者(12.3%)罹患乳腺癌的风险高于人群风险,这些患者被转介到家族癌症服务机构接受持续管理:讨论:7 名患者在参加 CBPC 的 12 个月内被确诊为乳腺癌。其中五名患者是通过到 CBPC 就诊确诊的,一名患者随后因出现新症状被转诊至 2WW 诊所,并在乳房X光检查中发现了隐匿性肿瘤,还有一名患者是在随后的常规乳房筛查邀请函中被确诊的。五名患者中有两名曾有乳腺癌病史,这也是 CBPC 的一项明确排除标准。仅有乳房疼痛且符合 CBPC 转诊标准的妇女的乳腺癌发病率为 4.8/1000,这证实该人群患乳腺癌的风险很低。患者对服务的满意度很高,99%(n=1022)的患者 "极有可能或可能 "推荐该服务:研究结果证实,该路径首次证明,在社区环境中,妇女可以安全地单独处理乳房疼痛问题,而且患者满意度很高。
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来源期刊
BMJ Open Quality
BMJ Open Quality Nursing-Leadership and Management
CiteScore
2.20
自引率
0.00%
发文量
226
审稿时长
20 weeks
期刊最新文献
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