Abstract
In the NHS Breast Screening Programme, cases where some diagnostic uncertainty remains following assessment may be recalled for a further appointment. Short-term recall (STR) rates and recall periods vary between screening services. There is a lack of published material to suggest who will benefit most from an STR appointment. Data were collected from the screening folders for 110 women put on STR following assessment, and for three women put on STR from STR in the financial year 2003/2004. The data collected included radiological appearance and opinion, biopsy results, reason for STR, and outcome. The most frequent reasons for women being put on STR were patient choice (18 cases, 16%), difficulty in biopsy (11 cases, 10%) and low yield of calcification in biopsy specimens (eight cases, 7%). The most frequent characteristics were calcification, benign or uncertain radiological appearance and a B1 (normal breast tissue) biopsy. At STR, 92 cases (84%) were found to be benign and returned to routine recall. Four women (3.6%) had invasive cancer, one woman had ductal carcinoma in situ, two women had a further 12-month STR and two women had open biopsy. For nine women (8%), the outcome of the STR appointment was unknown. The four invasive tumours were all from incident screens, one each of asymmetric distortion, micro-calcification, radial mass and appearance not recorded. From the three women on STR from STR, an additional invasive cancer was found and two women were returned to routine recall.
Highlights
Axillary lymph node dissection has been standard practice for staging invasive breast cancer
Best estimates for where to credit this dramatic drop in death rate place approximately 50% of the credit with improved adjuvant chemotherapy and 50% with mammography
Full field digital mammography (FFDM) had a higher detection rate for ductal carcinoma in situ (DCIS) but no difference was observed for invasive tumours
Summary
Axillary lymph node dissection has been standard practice for staging invasive breast cancer. Aim To assess the feasibility of surgeons performing breast US in symptomatic breast clinics either as an adjunct to triple assessment or on their own for diagnostic and therapeutic purposes. The performance of individual units is monitored to ensure all women have access to an excellent service Aim This project aims to demonstrate how the Liverpool Breast Unit addressed failure to meet the national quality standard for the benign. Method A retrospective review of the records of patients who had undergone benign biopsy (2001–2002) was conducted to establish reasons for surgical referral and suggest corrective measures to enable the unit to meet the standard in the future. Columnar cell change (CCC) is diagnosed on core biopsies performed for indeterminate microcalcification. Method Mammograms of 33 cases with established CCC on core biopsy were reviewed and the radiological features, follow-up imaging and surgical excision histology (if performed) were collated. The results were completed when all units were undergoing assimilation onto the new banding procedures
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