Utility of Virtual New-Patient Breast Surgery Clinics in Women Under 30 Years Old

Virtual consultations (VCs) have been utilized across various clinical specialties and have the potential to reduce outpatient clinic costs and improve patient satisfaction. In breast surgery, we aimed to assess the utility and feasibility of VC in new-patient clinics for women under 30, who are considered a low-risk subgroup.

Between December 2020 and April 2021, data were consecutively collected from 118 women aged under 30 who were referred from primary care to the breast clinic. Participants were offered VCs, followed by ultrasound (USS) if clinically indicated and/or face-to-face review. Clinicopathological data were collected on referrals, imaging, and follow-up, with descriptive statistics used for analysis.

An outpatient USS was performed by a sonographer trained in palpation for 80.3% (n = 94) of patients after a review in the VC clinic. In comparison, 15.4% (n = 18) of patients were reassured and discharged directly after the VC consultation. The USS was normal in 64.9% (n = 61) of patients, with the remainder showing benign pathology. Six biopsies were performed, all of which were benign. Only 14.4% (n = 17) of patients required a face-to-face appointment with a breast surgeon, and 64.1% (n = 75) of patients were discharged after VC + USS alone. Routine follow-up of benign disease was organized for 6.0% (n = 7) of patients, with one patient booked for elective surgery for benign disease. No adverse events were reported.

Utilizing VC, the majority of new referrals did not require face-to-face appointments, and the diagnosis rate is low in this younger age subgroup. VCs have the potential to reduce the burden on new-patient clinics and reduce costs while improving patient convenience. Larger studies with longer follow-up are needed to assess the long-term safety of this approach.