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NICaN Breast Cancer Self Directed Aftercare (SDA) Pathway Patients treated with curative intent MDM decision SURGICAL RESULTS CLINIC Patient IS suitable for SDA Approx Day 10 post surgery Complete mammography request Allocate PAS ‘Discharge Code’ for surgical episode. Thinking Ahead Leaflet Treatment Summary Record (if last treatment) Record in CaPPs MDM report MAMMOGRAPHIC SURVEILLANCE All females except those who have had bilateral mastectomies During last few weeks of treatment - Radio/chemo staff to update SDA suitability, patient assessment & offer Cancer Health & Well Being Event Patient led assessment, confirm suitability SDA, signpost to survivorship services Option to defer HNA to post oncology completion Refer if surgery only CANCER HEALTH & WELLBEING EVENT ONCOLOGIST POST TREATMENT REVIEW (3-6 months post radiotherapy +/- chemotherapy) Allocate PAS ‘attendance code’ & if required add to Hold & Treat Waiting list for Year 2/3 appt) Issue Treatment Summary Record May be provided through Cancer Centre / Unit if radiotherapy last treatment OR by Cancer Unit if surgery or chemo last treatment PATIENT/ GP concern ONCOLOGY STAFF (Year 2/3) appointment If hormone switch appropriate Clinical assessment by appropriately trained individual Allocate PAS attendance code & if required add to Hold & Treat Waiting list for Year 5 appt) BREAST CARE NURSE (triage call within 48 hours / 2 working days) ONCOLOGY STAFF Year 5 Review endocrine therapy, if applicable, clinical assessment, Final sign off ?extended adjuvant therapy as per NIBOG guidance Allocate PAS Discharge Code for oncology episode Final Sept 13 V9 Rapid Access to Breast Team or MDM CHEMOTHERAPY +/RADIOTHERAPY Clinical support services, Education & information, Physical activity, Other support services Survivorship services - Signpost or refer www.survivorship.cancerni.net BREAST CARE NURSE (6- 12 weeks post completion of treatment) Year 1 Mammogram If abnormal fast track Year 2 Mammogram If abnormal fast track Year 3 Mammogram If abnormal fast track Year 4 Mammogram If abnormal fast track Year 5 Mammogram If abnormal fast track Aged >50 years discharge to NHSBSP Aged <45 years annual mammograms until age 50 then discharge to NHSBSP