Improving the time to diagnosis after an abnormal screening mammogram

Introduction: Five community-specific interventions to reduce the time to d iagnosis after an abnormal breast screen have been evaluated. Methods: Subjects with abnormal screening mammograms in 1998 were assessed through five community pilot projects (N=1137) and a control random sample assessed elsewhere in BC (N=1053). The number, types, dates and physician c osts of breast-related interventions after an abnormal screen were compared between pilots and control. Results: The median time to diagnosis for women without a biopsy was reduce d from 23 days to 7 days (p = 0.001) in the pilot with facilitated referral to diagnosis. The median time to diagnosis for women with a biopsy was red uced from 57 days to 22-43 days in the pilots. Median physician costs per s ubject were lower (p = 0.021) in pilots that more frequently used core biop sy to obtain a diagnosis. Conclusions: Process changes can improve the time to diagnosis after an abn ormal breast screen, with similar or lower physician costs per subject. Fac ilitating the referral process had the greatest impact.