Quality standard

Quality statement 1: Timely diagnosis

Quality statement 1: Timely diagnosis

Quality statement

People with suspected breast cancer referred to specialist services are offered the triple diagnostic assessment in a single hospital visit. [new 2016]

Rationale

Early diagnosis of breast cancer allows for prompt treatment, which results in better health outcomes for people with breast cancer. Giving people with suspected breast cancer the triple diagnostic assessment at a single hospital visit will help to ensure rapid diagnosis. It will also help to reduce the anxiety and stress associated with multiple visits for different parts of the triple diagnostic assessment.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Process

Proportion of people with suspected breast cancer referred to specialist services who receive the triple diagnostic assessment in a single visit.

Numerator – the number in the denominator who receive the triple diagnostic assessment in a single visit.

Denominator – the number of people with suspected breast cancer referred to specialist services.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records. The National Audit of Breast Cancer in Older Patients reported the percentage of patients aged 50 years and over who were calculated to have received the triple diagnostic assessment in a single visit. The denominator is women with non-screen-detected early invasive breast cancer.

Outcome

a) Stage at diagnosis of breast cancer.

Data source: The National Disease Registration Service's stage at diagnosis report includes information on breast cancer staging data in England.

b) Breast cancer survival rates.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

What the quality statement means for different audiences

Service providers (such as secondary care services and specialist breast cancer services) ensure that systems are in place to provide triple diagnostic assessment in a single hospital visit for people referred to specialist services with suspected breast cancer.

Healthcare professionals (such as doctors, nurses and specialists) ensure that people with suspected breast cancer referred to specialist services have the triple diagnostic assessment in a single hospital visit.

Commissioners ensure that they commission specialist services that provide triple diagnostic assessment in a single hospital visit for people with suspected breast cancer.

People who have been referred to a breast cancer specialist are offered a full assessment carried out at a single visit to the hospital or specialist unit. The assessment involves an examination, breast imaging and a biopsy (if needed). During the biopsy, a small amount of breast tissue is removed and tested for cancer. Having the assessment in a single visit helps to ensure that people receive a quick diagnosis and do not need to make several hospital visits.

Definitions of terms used in this quality statement

Triple diagnostic assessment

This consists of clinical assessment, mammography and/or ultrasound imaging, and fine-needle aspiration or core biopsy. [NICE's guideline on improving outcomes in breast cancer, page 33]