www.virgincare.co.ukPrivate and confidential1

BREAST SERVICES IN GUILDFORD

Julie Cooke Consultant Radiologist

Jarvis Screening Centre and Royal Surrey County Hospital, Guildford

www.virgincare.co.uk

What is available

NHS Breast screening programme– Jarvis Centre

Symptomatic breast services– Jarvis Centre– Royal Surrey County Hospital– Ashford/St Peters– Frimley Park Hospital – Surrey and Sussex Healthcare

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NHS Breast Screening

Asymptomatic population screening,– call and recall

3 yearly

Usually on mobile units

Age range 50-70

Age extension randomisation – trial 47-50 and 70-73

Over 70 (73) self refer

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Key prognostic indicators, breast screening (2013-14)

Uptake to invitation 71% (>70%)

Recall rate 6.0%

Cancer detection 7.4/1,000 (=>4.1)

Round length (how may screened within 36 months of previous screen)

– 97% (=>90%)

Process targets– Screen to results 99% (=>90%)– Screen to date of first offered assessment 93% (=>90%)– Date of attendance at assessment 84.5% (=>90)

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Screening problems

3 year cycle, so uptake variable

Referrals to acute trusts with breast cancer diagnosis depends on van location, peaks and troughs

Staff holidays, sickness, maternity leave, gaps in cover

Low areas of uptake– Ethnic minorities, Woking, Spelthorne

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Marmot reportCancer UK Department of Health 2012

Breast cancer deaths

20% reduction in breast cancer mortality

One death prevented for every 235 invited (180 attended )

1300 deaths prevented per year

22,000 years of life saved per year

For 10,000 women invited, age 50+, 20 years, – 681 cancers diagnosed, 43 deaths prevented

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Over diagnosis

Detection of a cancer that would not have come to light in the woman's lifetime

11% for population and 19% from woman's perspective

DCIS; 10% will develop invasive disease within 10 years

For 10,000 women invited, age 50+, 20 years– 681 cancers diagnosed, 43 deaths prevented– 129 cancers over diagnosed (19% estimate)

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Breast cancer treatment

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Wide local excisionRadiotherapyHormone therapyMastectomyReconstructionChemotherapy

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Symptomatic breast referrals

Urgent, cancer suspected (TWR); seen within 2 weeks– Refer to RSCH or other acute trusts

Non urgent; seen within 2 weeks– Refer to Jarvis or RSCH, or acute trusts– The choice is yours

Why has the Jarvis stopped seeing urgent (TWR) referrals

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Urgent, cancer suspected (TWR)

Two weeks from referral to appointment (93%)

31 days from decision to treat to 1st treatment (96%)

62 days from referral to 1st treatment (85%)

62 days from attendance at screen to 1st treatment (90%)

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Refer 2 weeks 31 62 Rx

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Non urgent referrals, cancer not suspected

Two weeks from referral to appointment (93%)

Diagnosis can take longer as on different pathway

31 days from decision to treat to 1st treatment (96%)Family history and cosmetic referrals are excluded

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Refer 2 weeks Rx Cancer 31days 62 days decision

No cancer 18 week

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Be Clear on Cancer

1 in 3 women who get breast cancer are over 70,

so don’t assume you’re past it

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Feb/March 2014

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THANK YOU

Any questions?

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