Pathway times in the mammography programme before and after introduction of the breast cancer care pathway

The purpose of introducing the 'cancer patient pathway for breast cancer' was to ensure a coherent treatment pathway without unnecessary delays. Radiologists and pathologists who work with breast diagnostics are involved in both cancer patient pathways and BreastScreen Norway. The extent to which this policy may have affected waiting times has not been analysed previously. This study presents waiting times in BreastScreen Norway before and after introduction of cancer patient pathway.

We analysed waiting times associated with 1 485 240 screening examinations undertaken as part of BreastScreen Norway in the period 01.7.2011-30.6.2018, stratified by breast diagnostic centre. Waiting times were defined as the number of calendar days from the a) screening examination to the dispatch of the negative results letter (dispatch time), b) screening examination to the date on which the follow-up examination was performed (follow-up examination time) and c) follow-up examination to diagnosis (diagnosis time). Data were retrieved from the Cancer Registry of Norway's databases. Use of these is set out in the Cancer Registry Regulations. We calculated median waiting times in addition to 90th percentiles.

The median dispatch time was 13 days before the cancer patient pathway was introduced, and 12 days after. The median follow-up examination time increased from 23 to 27 days, while the median diagnosis time was 3 days both before and after introduction of the cancer patient pathway.

Dispatch and diagnosis times were unchanged, or slightly changed after introduction of the cancer patient pathway, while follow-up examination time increased somewhat. Introduction of the cancer patient pathway may have led to differential adjustments in priorities, workflows and access to resources between the breast diagnostic centres.