Improving the time to diagnosis after an abnormal screening mammogram.

INTRODUCTION

Five community-specific interventions to reduce the time to diagnosis after an abnormal breast screen have been evaluated.

METHODS

Subjects with abnormal screening mammograms in 1998 were assessed through five community pilot projects (N = 1137) and a control random sample assessed elsewhere in BC (N = 1053). The number, types, dates and physician costs of breast-related interventions after an abnormal screen were compared between pilots and control.

RESULTS

The median time to diagnosis for women without a biopsy was reduced from 23 days to 7 days (p = 0.001) in the pilot with facilitated referral to diagnosis. The median time to diagnosis for women with a biopsy was reduced from 57 days to 22-43 days in the pilots. Median physician costs per subject were lower (p = 0.02) in pilots that more frequently used core biopsy to obtain a diagnosis.

CONCLUSIONS

Process changes can improve the time to diagnosis after an abnormal breast screen, with similar or lower physician costs per subject. Facilitating the referral process had the greatest impact.