Breast cancer follow-up: a radiographer-led service

Velindre Cancer Centre treats and follows up a range of malignancies. Historically the management of breast cancer has been annual follow-up and, having no formal discharge policy, clinics have become steadily more unmanageable. It was decided to streamline the system by providing a radiographer-led service. National Institute for Clinical Excellence guidelines (Improving Outcomes in Breast Cancer) provide the criteria for patients' admission into this service.

At annual mammography, a comprehensive health questionnaire is used to determine disease status and set protocols exist to allow referral to the breast care team if required.

The senior radiographer leading the service ensures that those patients who are given a normal report receive a letter informing them of the result, as well as arranging their next annual mammogram. The results and any actions taken are annotated electronically onto the hospital information system and supplemented with a weekly forum with the breast team to disseminate information and monitor the system.

This system has run since May 2003 resulting in patients requiring only one hospital visit per year, while allowing more time with the health professionals. The radiographer benefits through role extension and better use of existing skills. The clinics are less fraught, with more time allocated to patients.