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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