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BREAST SERVICES IN GUILDFORD
Julie Cooke Consultant Radiologist
Jarvis Screening Centre and Royal Surrey County Hospital,
Guildford
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Private and confidential
www.virgincare.co.uk
What is available
NHS Breast screening programme
– Jarvis Centre
Symptomatic breast services
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–
–
–
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Jarvis Centre
Royal Surrey County Hospital
Ashford/St Peters
Frimley Park Hospital
Surrey and Sussex Healthcare
Private and confidential
www.virgincare.co.uk
NHS Breast Screening
Asymptomatic population screening,
– call and recall
3 yearly
Usually on mobile units
Age range 50-70
Age extension randomisation
– trial 47-50 and 70-73
Over 70 (73) self refer
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Private and confidential
www.virgincare.co.uk
Key prognostic indicators, breast screening
(2013-14)
Uptake to invitation 71% (>70%)
Recall rate 6.0%
Cancer detection 7.4/1,000 (=>4.1)
Round length (how may screened within 36 months of previous screen)
– 97% (=>90%)
Process targets
– Screen to results 99% (=>90%)
– Screen to date of first offered assessment 93% (=>90%)
– Date of attendance at assessment 84.5% (=>90)
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Private and confidential
www.virgincare.co.uk
Screening problems
3 year cycle, so uptake variable
Referrals to acute trusts with breast cancer diagnosis
depends on van location, peaks and troughs
Staff holidays, sickness, maternity leave, gaps in cover
Low areas of uptake
– Ethnic minorities, Woking, Spelthorne
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Private and confidential
www.virgincare.co.uk
Marmot report
Cancer UK
Department of Health 2012
Breast cancer deaths
20% reduction in breast cancer mortality
One death prevented for every 235 invited (180 attended )
1300 deaths prevented per year
22,000 years of life saved per year
For 10,000 women invited, age 50+, 20 years,
– 681 cancers diagnosed, 43 deaths prevented
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Private and confidential
www.virgincare.co.uk
Over diagnosis
Detection of a cancer that would not have come to light in
the woman's lifetime
11% for population and 19% from woman's perspective
DCIS; 10% will develop invasive disease within 10 years
For 10,000 women invited, age 50+, 20 years
– 681 cancers diagnosed, 43 deaths prevented
– 129 cancers over diagnosed (19% estimate)
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Private and confidential
www.virgincare.co.uk
Breast cancer treatment
Wide local excision
Radiotherapy
Hormone therapy
Mastectomy
Reconstruction
Chemotherapy
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Private and confidential
www.virgincare.co.uk
Symptomatic breast referrals
Urgent, cancer suspected (TWR); seen within 2 weeks
– Refer to RSCH or other acute trusts
Non urgent; seen within 2 weeks
– Refer to Jarvis or RSCH, or acute trusts
– The choice is yours
Why has the Jarvis stopped seeing urgent (TWR) referrals
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Private and confidential
www.virgincare.co.uk
Urgent, cancer suspected (TWR)
Two weeks from referral to appointment (93%)
31 days from decision to treat to 1st treatment (96%)
62 days from referral to 1st treatment (85%)
62 days from attendance at screen to 1st treatment (90%)
Refer
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Private and confidential
2 weeks
31
Rx
62
www.virgincare.co.uk
Non urgent referrals, cancer not suspected
Two weeks from referral to appointment (93%)
Diagnosis can take longer as on different pathway
31 days from decision to treat to 1st treatment (96%)
Family history and cosmetic referrals are excluded
Refer
2 weeks
Rx Cancer
decision
No cancer
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Private and confidential
31days
62 days
18 week
www.virgincare.co.uk
Be Clear on Cancer
1 in 3 women who get breast cancer are over 70,
so don’t assume you’re past it
Feb/March 2014
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Private and confidential
www.virgincare.co.uk
THANK YOU
Any questions?
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Private and confidential
www.virgincare.co.uk