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Updated: Jul 8, 2026

Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial

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Published on: August 19, 2025

Managing the 2-week wait for breast patients.

Rishi Singhal¹, Ravi Marudanayagam, B Balasubramanian

¹Breast Unit, Heart of England NHS Foundation Trust, Birmingham, UK. singhal_rishi@rediffmail.com

Annals of the Royal College of Surgeons of England

|January 19, 2008

Summary

The fast-track breast clinic system is efficient for diagnosing breast cancer, detecting 91.8% of cancers. This system significantly outperforms routine referrals, highlighting its value in breast cancer detection.

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Area of Science:

Oncology
Surgical Oncology
Breast Surgery

Background:

Traditional 2-week wait and triple assessment models for breast referrals may be outdated.
Studies indicate a significant proportion of breast cancers originate from routine referrals.
The high volume of referrals poses a challenge to meeting the 2-week target.

Purpose of the Study:

To analyze the performance of the established fast-track breast clinic system.
To evaluate the effectiveness of the fast-track system in diagnosing breast cancer.
To compare the diagnostic yield of fast-track versus routine referrals.

Main Methods:

Prospective audit data from Birmingham Heartlands and Solihull fast-track clinics (1999-2005) were retrospectively analyzed.
Data were cross-referenced with the cancer database to determine referral origin.
Analysis included the appropriateness of fast-track referrals.

Main Results:

Over 5 years, 14,303 patients were seen; 91.8% of 1095 cancers were from fast-track clinics (16.4% pick-up rate).
Routine referrals accounted for 8.2% of cancers with a 1.3% pick-up rate (P < 0.001).
Cancer detection was significantly higher for appropriate fast-track referrals (14.4%) versus inappropriate ones (0.55%, P < 0.001).

Conclusions:

The fast-track, triple assessment breast clinic model is an efficient diagnostic system.
The study recommends the continuation of the dual referral system (fast-track and routine).
The fast-track system demonstrates superior performance in breast cancer detection.