Bristol Breast Care Centre, North Bristol NHS Trust, Southmead Hospital, Westbury-On-Trym, UK.
Breast J. 2021 Mar;27(3):248-251. doi: 10.1111/tbj.14134. Epub 2020 Dec 26.
Symptomatic presentations account for the majority of invasive breast cancer diagnoses. While the National Health Service Breast Screening Programme is subjected to strict quality control, no such system for performance monitoring exists in the symptomatic clinic. We assess the sensitivity of cancer detection and missed cancer rate for symptomatic breast patients to benchmark future outcome measures.
A retrospective cohort study of patients attending the symptomatic breast clinic between October 2013 and October 2018 was performed. Patients with new cancer diagnoses were identified and screened for those who had presented to the department within the 3 years prior to their diagnosis. From this, the sensitivity and missed cancer rate were calculated.
About 40 323 patients were seen over the 5-year study period. About 2155 new cancers were diagnosed, with 2033 identified at their initial clinic attendance. A further 122 patients had cancer diagnosed on a subsequent appointment, of which 23 patients were considered to have had a delay in diagnosis. The sensitivity of the one-stop symptomatic breast clinic was therefore 99.0%, and the missed cancer rate was 0.06% over 5 years.
The missed cancer rate reported in this study is favorable compared to the outcomes reported in the National Health Service Breast Screening Programme and superior to the only other study reporting outcomes on a much smaller cohort. The unit in question therefore is performing exceptionally against current standards and sets a benchmark against which future performance can be measured.
有症状的表现占了大多数浸润性乳腺癌的诊断。虽然国民保健制度乳房筛查计划受到严格的质量控制，但在有症状的诊所中并没有这样的绩效监测系统。我们评估了癌症检测的敏感性和漏诊癌症率，以便为未来的结果衡量指标提供基准。
对 2013 年 10 月至 2018 年 10 月期间在有症状的乳房诊所就诊的患者进行了回顾性队列研究。对新诊断癌症的患者进行了识别，并对在诊断前 3 年内到科室就诊的患者进行了筛查。由此计算了敏感性和漏诊癌症率。
在 5 年的研究期间，大约有 40323 名患者就诊。约有 2155 例新癌症被诊断出，其中 2033 例在初次就诊时被发现。另有 122 例患者在随后的就诊中被诊断出癌症，其中 23 例被认为有诊断延误。因此，一站式有症状乳房诊所的敏感性为 99.0%，5 年内的漏诊癌症率为 0.06%。
与国民保健制度乳房筛查计划报告的结果相比，本研究报告的漏诊癌症率是有利的，并且优于仅对规模小得多的队列报告结果的另一项研究。因此，有问题的单位在当前标准下表现出色，为未来的绩效提供了衡量基准。
