651 Can Two Week Wait Breast Cancer Referrals Be Triaged to Prioritise High Risk Patients for Early Diagnosis and Treatment?

Abstract

Introduction NHS England state there should be a maximum 62-day wait from urgent GP referral to first definitive treatment in 95% of patients. Within this timeframe is the two-week wait (TWW) target from urgent GP referral to first outpatient appointment. This audit aims to identify those at higher risk of a cancer diagnosis and prioritise their outpatient appointment. Method A retrospective analysis was conducted of patients on a 62-day breast cancer pathway treated at the Royal Surrey County Hospital (RSCH), from February to July 2019. TWW was identified as a common rate-limiting step. Further analysis of September 2019 allowed the contents of GP referrals to be correlated with subsequent diagnoses. Results 40% of breast cancer patients breached the 62-day target in this 6-month period; the mean TWW was 11.5 days. In September, 266 referrals were received with a cancer detection rate of 3.95%. The most specific referral characteristic was personal history of a breast cancer. Breast lumps in the >30s are more specific than in the <30s (6.8% versus 0%). Conclusions Designated clinics for breast pain and lumps for <30s, would relieve pressure on the high volume of referrals made to TWW clinics, reducing delay to diagnosis and treatment for those most at risk