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  • Poster presentation
  • Open Access

An audit to assess the impact of introducing a protocol of bilateral whole breast and axillary ultrasound for assessment of screen-detected cancers

  • 1 and
  • 2
Breast Cancer Research201012 (Suppl 3) :P29

  • Published:


  • Breast Cancer
  • Axillary Node
  • Invasive Disease
  • Biopsy Result
  • Repeat Operation


Our protocol for assessment of women with screen-detected malignancy was changed to include bilateral whole breast and axillary ultrasound (BBUS) following a prospective study that confirmed the benefit of this in 2002 [1]. This audit assesses the impact of introducing this change.


Biopsy results for all women with screen-detected cancer diagnosed between April 2003 and March 2009 were reviewed to identify cases where multiple biopsies had been performed. The reason for additional biopsy and subsequent management were recorded. The data were compared with control data (2001) obtained prior to the introduction of the protocol, and with national outcome data for screen-detected cancer.


A total of 199,307 women were screened during the audit period, and 1,700 women were diagnosed with breast cancer. Table 1 demonstrates the findings for women diagnosed with cancer who had additional biopsies, compared with the control population. Data for 2008/09 show that this unit has a repeat operation rate of 18% for non-invasive disease and 16% for invasive disease compared with national averages of 28% for non-invasive and 23% for invasive cancer [2].

Table 1


Audit (n = 1,700)

Control (n = 105)

Additional biopsy

318 (19%)

6 (5.7%)

Additional biopsy shows cancer

160 (9.4%)

6 (5.7%)

Contralateral biopsies

47 (2.8%)

0 (0%)

Bilateral cancer

22 (1.3%)

0 (0%)

FNAC of axillary node

150 (8.8%)

0 (0%)

FNAC shows nodal metastases

55 (3.2%)

0 (0%)


Additional cancers and axillary node metastases were detected as a result of introducing a policy of proactive assessment of disease extent. The unit has a favourable rate of re-operations compared with national data.

Authors’ Affiliations

Guy’s and St Thomas’ Hospitals NHS Trust, London, UK
St George’s Hospital, London, UK


  1. Wilkinson LS, Given-Wilson R, Hall T, Potts H, Sharma AK, Smith E: Increasing the diagnosis of multifocal primary breast cancer by the use of bilateral whole-breast ultrasound. Clin Radiol. 2005, 60: 573-578. 10.1016/j.crad.2004.10.015.View ArticlePubMedGoogle Scholar
  2. West Midlands Cancer Intelligence Unit: National NHSBSP and ABS at BASO Breast Screening Audit 2008/9 report. []


© Perera and Wilkinson; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd.