Audit of short-term recall in the National Health Service Breast Screening Programme in the West Midlands

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.