TITLE:
Are Family Doctors Compliant with Breast Family History Guidelines?
AUTHORS:
Joe Thomas, Michael Sugrue, Sharon Curran, Michelle Furey, Ryan Sugrue
KEYWORDS:
Referral Guidelines; Family History; Breast Cancer; Risk Assessment
JOURNAL NAME:
Advances in Breast Cancer Research,
Vol.2 No.4,
September
23,
2013
ABSTRACT: Introduction: Optimizing
breast cancer care involves accurate risk assessment. Referrals to secondary
care need to be appropriate both in terms of healthcare resource utilisation
and the reduction of unnecessary patient anxiety. Aim: This study undertook an
evaluation of family doctors compliance with NICE guidelines for asymptomatic
family history referrals to a breast unit. Methods: A retrospective audit of general practice in County Donegal was
carried out between January 2010 and May 2011. NICE guidelines and IBIS
computerised model were used to assess whether referrals were appropriate. Results: 77.6%
(90/116) met a criterion for secondary care referral. 51.7% (60/116) met the NICE criteria and 64.7%
(75/116) met the IBIS criteria for referral to secondary care. 38.8% (45/116)
met both. 6 were of low risk, 45 were of moderate risk and 1 was of high risk. 80.4% (45/56) of the patients who did not meet the NICE
criteria, failed to do so because they had one 1st degree relative
with breast cancer who was over the age of 40. Conclusion: 77.6% of referrals complied with international criteria
for referral to secondary care. A greater understanding of what constitutes appropriate
referral of 1st degree relatives would enhance the referral process.