Improving the time to diagnosis after an abnormal screening mammogram

Abstract

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.