Managing the 2-week wait for breast patients.

Singhal, Rishi, Marudanayagam, Ravi, Balasubramanian, Balapathiran and Paterson, I S (2008) Managing the 2-week wait for breast patients. Annals of the Royal College of Surgeons of England, 90 (1). pp. 69-71. ISSN 1478-7083.

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Published data suggest that the 2-week wait system and triple assessment at one fast-track clinic visit is an out-dated method of capturing disease from a referral population. These studies report up to 32% of breast cancer coming from routine referrals. It has been recommended, therefore, that all breast referrals should be seen within 2 weeks. The sheer volume of referrals are likely to prevent this target being achieved. The aim of this study was to analyse the performance of our fast-track system.


The Birmingham Heartlands and Solihull fast-track clinics were set up in 1999 with a prospective audit system. The data from this audit were retrospectively analysed and cross-referenced with the cancer data base to determine the referral origin of breast cancers from November 1999 to February 2005.


A total of 14,303 (fast-track, n = 6678; routine referral, n = 7625) patients were seen over a 5-year period. Overall, 1095 cancers (91.8% of the total) came from the fast-track clinics which had a pick-up rate of 16.4% compared with 98 cancers (8.2% of the total) and a pick-up rate of 1.3% for routine referrals (P < 0.001). The appropriateness of fast-track referral was also analysed which showed that 14.4% of cancers were detected if the referral criteria were met compared to 0.55% if they were inappropriate (P < 0.001).


The traditional fast-track, triple assessment breast clinic is an efficient and well-structured way of diagnosing disease. We recommend that the two system referral pattern should continue.

Item Type: Article
Subjects: WO Surgery
WP Gynaecology. Women’s health
Divisions: Planned IP Care > General Surgery
Womens and Childrens
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Depositing User: Users 7 not found.
Date Deposited: 17 Jun 2014 10:42
Last Modified: 17 Jun 2014 10:42

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