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Current patterns of referral in breast disease
C RoshanLall1, S Leinster, S Mitchell
1The Breast Unit, Royal Liverpool University Hospital, Liverpool, UK.
Breast (Edinburgh, Scotland)
|February 18, 2004
Summary
Younger women referred to breast clinics with symptoms often do not need further investigation. Clinical examination and reassurance are adequate for those under 40 without a discrete lump or family history.
Area of Science:
- Oncology
- Radiology
- General Practice
Background:
- Breast cancer diagnosis in symptomatic women is a key area of clinical audit.
- Understanding age-related diagnostic patterns is crucial for optimizing referral pathways.
- Previous guidelines suggest a conservative approach for younger women.
Purpose of the Study:
- To audit symptomatic breast referrals in 1998.
- To determine the main diagnoses in relation to patient age.
- To identify patients reassured and discharged without investigation.
Main Methods:
- Retrospective audit of 3199 general practitioner referrals to a breast unit in 1998.
- Analysis of diagnoses based on patient age.
- Categorization of patients by investigation status.
Main Results:
- Overall, 8.7% of referrals were diagnosed with cancer, while 91.3% had non-malignant diagnoses.
- In women under 40, only 18 of 1231 (1.5%) were diagnosed with cancer.
- Of women under 40 diagnosed as normal, 14% (174) received no further investigation.
Conclusions:
- The study confirms Department of Health guidelines for younger women.
- Clinical examination and reassurance are adequate for women under 40 without discrete lumps or family history.
- Empowers general practitioners to confidently reassure younger patients presenting without a discrete lump.