Breast Disorders

Lockwood, Robert M.; Collings, Jamie L.

doi:10.1016/b978-1-4377-3548-2.00127-0

Cited by 1 publication

(1 citation statement)

References 20 publications

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“…4 The etiology of a new mass is highly dependent on the age of the patient, with most palpable masses representing benign disease in a premenopausal woman and up to 70% of masses representing a malignancy in a 75-year old woman. 5 Given this risk, performing appropriate work-up and ensuring follow-up after index presentation are paramount to providing a timely diagnosis and treatment, particularly for disadvantaged populations. Jaiswal et al performed a retrospective analysis of patients who received breast cancer care at a safety net hospital in Denver to identify factors associated with delays in diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

Urgent Breast-Related Consults Seen by Acute Care Surgery at a Safety Net Hospital

Sargent

Schellenberg

Owattanapanich

et al. 2022

The American Surgeon™

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Background Classically, urgent breast consults are seen by Breast Surgery or Surgical Oncology (BS/SO). At our safety net hospital, Acute Care Surgery (ACS) performs all urgent surgical consultations, including initial assessment of breast consults with coordinated BS/SO follow-up. The objective was to determine safety of ACS initial assessment of acute breast pathology. Methods All urgent breast-related consultations were included (2016-2019). Demographics, consult indications, and investigations/interventions were captured. Outcomes were compared between patients assessed by ACS versus both ACS and BS/SO at presentation. Results 234 patients met study criteria, with median age 39 years. Patients were primarily Hispanic (82%) women (96%). Most were not seen by BS/SO at presentation (69%), although BS/SO assessment was more frequent among patients ultimately diagnosed with cancer (8% vs 1%, P = .012). No patient had delay >90 days to core biopsy from presentation. Outcomes including time to cancer diagnosis (14 vs 8 days, P = .143) and outpatient BS/SO assessment (16 vs 13 days, P = .528); loss to follow-up (25% vs 21%, P = .414); and ED recidivism (24% vs 18%, P = .274) were comparable between patients seen by ACS versus ACS/BS/SO at index presentation. Conclusion Urgent breast consults at our safety net hospital typically underwent initial assessment by ACS with outpatient evaluation by BS/SO. Time to follow-up and cancer diagnosis, loss to follow-up, and ED recidivism were similar after index presentation assessment by ACS versus ACS and BS/SO. In a resource-limited environment, urgent breast consults can be safely managed in the acute setting by ACS with coordinated outpatient BS/SO follow-up.

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Section: Discussionmentioning

confidence: 99%