Age and sex can predict cancer risk in people referred with breast symptoms

Over the last decade, more than 5 million patients were referred to secondary care with breast symptoms. In 2021-22, 40% of referred patients waited longer than the recommended 14 days for clinic assessment. Urgent referral rates increased considerably after 2015, especially in patients aged 30-59. One significant contributing factor is due to the NICE recommendations, which advocates urgent referral for patients if the breast cancer risk is >3%.  Given these challenges of managing patient referral volumes, breast service review has been recommended. The recently adopted 28 day faster diagnosis standard provides opportunities to enable a more flexible timescales for specialist assessment in different patient groups. For example, although 50% of referrals for women <30 years old are deemed urgent, this patient group has a low cancer detection rate of 0.5%. Male patient referral accounts for 5% of all referrals, and 2/3 are referred along urgent pathway. However, their cancer diagnosis rate is <3% across all age groups. In contrast, women >70 years old have cancer diagnosis rate of >4% even when referred routinely. This patient group accounts for 1/3 of all breast cancer diagnosis. Therefore, risk adopted approaches based on existing national data could reduce time to diagnosis for those at highest risk, alleviate existing service pressures, and maintain adherence to NICE recommendations.

Classifications: Breast Cancer Risk

Keywords: High risk factors