Comparison of the urgent referral for suspected breast cancer process with patient age and a predictive multivariable model.

Background: The urgent 2-week wait referral for suspected breast cancer system (U2WW) in the UK prioritizes primary care referrals to one-stop breast clinics as 'urgent' or 'choose and book' (C&B). The aim of this study was to evaluate the accuracy of U2WW in discriminating cancer versus no cancer, and to consider alternative criteria.

Methods: Clinical features elicited in primary care and demographics of consecutive female patients in a specialist breast clinic were collated at the time of consultation from May 2008 to July 2017.

The case for the omission of axillary staging in invasive breast carcinoma that exhibits a predominant tubular growth pattern on preoperative biopsy.

True invasive tubular breast carcinoma (TBC) is unlikely to metastasize to axillary nodes, yet it is routinely subjected to sentinel lymph node biopsy (SLNB), even if the diagnosis was suspected preoperatively. The positive predictive value (PPV) of core biopsy for TBC and the incidence and predictors of axillary metastasis in invasive breast carcinomas identified as tubular-rich on core biopsy are unknown. Prospective patient and tumor data regarding postoperatively confirmed TBCs, and tubular-rich carcinoma identified on preoperative core biopsy between January 2005 and May 2016 was analyzed retrospectively.

Factors that influence volume and duration of wound drainage after mastectomy and level III axillary node clearance.

Factors influencing drainage after operations for breast cancer remain controversial. The total volume and duration of drainage was prospectively measured in 252 women undergoing mastectomy and level III axillary clearance, and compared to patient, operative and tumour factors, using multivariate analysis. The total drainage and duration, respectively, correlated with the weight of the patient (r=0.

Impact of the '2 week wait' directive for suspected cancer on service provision in a symptomatic breast clinic.

Background: The '2 week wait' directive (Health Service Circular (HSC) 1998/242) guaranteeing that 'everyone with suspected breast cancer will be able to see a specialist within two weeks of their general practitioner (GP) deciding they need to be seen urgently' is a unique audited approach to access for the British National Health Service, the effects of which have been assessed in a non-academic symptomatic breast clinic.

Methods: New GP referrals (n = 607) were reviewed prospectively in two comparable 3-month intervals, beginning 1 April 1998 and 1 April 1999, to determine the probability of a breast cancer diagnosis from the referral letter and the effects of the directive on waiting times for appointments and utilization of clinics.

Results: The urgency of referral was not specified in 53 per cent of GP referrals.