Audit of general practitioner referrals for breast pain to rapid access breast clinics at North Cheshire NHS Trust Hospital

Purpose

The audit was a retrospective study to examine the number of general practitioner (GP) referrals for breast pain and to assess the number of women imaged and the outcomes.

Methods

Between 1 June and 31 December 2005 there were 945 referrals to the Rapid Access Breast Clinic (RABC), of which 222 were for breast pain. Data collected included age, examination requested, clinical information on imaging request, unilateral or bilateral pain, status of requesting clinician and outcome.

Results

Age range of referrals: under 35 years = 10%, 35–50 years = 56%, 51+ years = 34%. Of the 945 referrals, 23% were for breast pain. Of the 222 women presenting with pain, 77% were imaged. Of the number imaged, 83% had unilateral pain and 17% had bilateral pain. The two consultant teams, each with either a registrar or SHO, showed a significant difference in the amount of imaging requested. There were 118 mammograms and 56 ultrasound examinations requested.

Outcomes of imaging

There were no malignancies detected. Ninety-three per cent had no significant findings. Of the 7% with an abnormality, seven were cysts, one was a calcified fibro-adenoma, three were incidental findings of microcalcification, and two asymmetrical densities were proven normal.

Conclusion

Of all the women referred to clinic, very few abnormalities were detected (no cancers). Audit results have been disseminated to Trust Consultants, and all referring GPs.

GPs should be supplied with local guidelines for the management and referral of breast pain. They should be encouraged to give out information booklets about breast pain.

There should be a consensus between all Breast Clinicians regarding imaging criteria for breast pain.