Transforming care with community breast pain clinics: a validated innovative solution benefitting patients and the healthcare system.

Abstract

Literature shows that breast pain alone has no significant association with breast cancer. Currently, patients experiencing these symptoms are often referred to breast cancer diagnostic clinics (BCDCs), leading to an increase in unnecessary anxiety and overutilisation of already strained secondary care resources. The East Midlands Breast Pain Pathway (EMBPP) aims to establish a new pathway that improves patient care and eases pressure on BCDCs, as well as being cost-beneficial and providing a positive patient experience. This study aims to evaluate the impact of the EMBPP on patient care, including safety, costs incurred by the health system and patient experience. The EMBPP was analysed quantitatively and qualitatively using data extracted from the community breast pain clinics (CBPCs), BCDCs, patient-reported outcome measures, clinic costs, family history data and staff interviews. Breast cancer incidence within the cohort of patients with a full 12-month follow-up period was shown to be 3.7 per 1000 patients, below the population estimates in the literature. There was no delay to care for those who were diagnosed with breast cancer after attending a CBPC. The clinics were found to be cost-beneficial, with a cost-benefit ratio of 1.26 in year 1, 1.40 in year 2 and 1.56 in year 3. The pathway was positively received by patients, with 98.7% indicating that they would recommend the service. Following on from previous audits and analysis of the EMBPP pathway, this national evaluation has shown that CBPCs are effective across multiple Cancer Alliances, National Health Service (NHS) Trusts and demographics. The CBPC offers a positive patient experience and is cost-beneficial and safe, with no evidence of a delay to care for the patients.