Transforming care with community breast pain clinics: a validated innovative solution benefitting patients and the healthcare system

Rationale Literature shows that breast pain alone has no significant association with breast cancer. Currently, patients experiencing these symptoms are often referred to breast cancer diagnostic clinics (BCDCs), leading to an increase in unnecessary anxiety and overutilisation of already strained s...

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Main Authors: John Robertson, Emily Griffiths, Thilan Bartholomeuz, Veronica Rogers, Mark Sibbering, Kevin Clifton, Izaak Gilchrist
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:BMJ Open Quality
Online Access:https://bmjopenquality.bmj.com/content/14/3/e003363.full
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author John Robertson
Emily Griffiths
Thilan Bartholomeuz
Veronica Rogers
Mark Sibbering
Kevin Clifton
Izaak Gilchrist
author_facet John Robertson
Emily Griffiths
Thilan Bartholomeuz
Veronica Rogers
Mark Sibbering
Kevin Clifton
Izaak Gilchrist
author_sort John Robertson
collection DOAJ
description Rationale Literature shows that breast pain alone has no significant association with breast cancer. Currently, patients experiencing these symptoms are often referred to breast cancer diagnostic clinics (BCDCs), leading to an increase in unnecessary anxiety and overutilisation of already strained secondary care resources. The East Midlands Breast Pain Pathway (EMBPP) aims to establish a new pathway that improves patient care and eases pressure on BCDCs, as well as being cost-beneficial and providing a positive patient experience.Aim and objectives This study aims to evaluate the impact of the EMBPP on patient care, including safety, costs incurred by the health system and patient experience.Methods The EMBPP was analysed quantitatively and qualitatively using data extracted from the community breast pain clinics (CBPCs), BCDCs, patient-reported outcome measures, clinic costs, family history data and staff interviews.Results Breast cancer incidence within the cohort of patients with a full 12-month follow-up period was shown to be 3.7 per 1000 patients, below the population estimates in the literature. There was no delay to care for those who were diagnosed with breast cancer after attending a CBPC. The clinics were found to be cost-beneficial, with a cost-benefit ratio of 1.26 in year 1, 1.40 in year 2 and 1.56 in year 3. The pathway was positively received by patients, with 98.7% indicating that they would recommend the service.Conclusion Following on from previous audits and analysis of the EMBPP pathway, this national evaluation has shown that CBPCs are effective across multiple Cancer Alliances, National Health Service (NHS) Trusts and demographics. The CBPC offers a positive patient experience and is cost-beneficial and safe, with no evidence of a delay to care for the patients.
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spelling doaj-art-ffda6fb173e340c88231f66401f46d0c2025-08-21T03:35:12ZengBMJ Publishing GroupBMJ Open Quality2399-66412025-08-0114310.1136/bmjoq-2025-003363Transforming care with community breast pain clinics: a validated innovative solution benefitting patients and the healthcare systemJohn Robertson0Emily Griffiths1Thilan Bartholomeuz2Veronica Rogers3Mark Sibbering4Kevin Clifton5Izaak Gilchrist61 University Hospitals of Derby and Burton Foundation Trust, Derby, UK1 University Hospitals of Derby and Burton Foundation Trust, Derby, UK2 Mid-Nottinghamshire Place Based Partnership, Nottingham, UK1 University Hospitals of Derby and Burton Foundation Trust, Derby, UK1 University Hospitals of Derby and Burton Foundation Trust, Derby, UK3 Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, UK4 Edge Health, London, UKRationale Literature shows that breast pain alone has no significant association with breast cancer. Currently, patients experiencing these symptoms are often referred to breast cancer diagnostic clinics (BCDCs), leading to an increase in unnecessary anxiety and overutilisation of already strained secondary care resources. The East Midlands Breast Pain Pathway (EMBPP) aims to establish a new pathway that improves patient care and eases pressure on BCDCs, as well as being cost-beneficial and providing a positive patient experience.Aim and objectives This study aims to evaluate the impact of the EMBPP on patient care, including safety, costs incurred by the health system and patient experience.Methods The EMBPP was analysed quantitatively and qualitatively using data extracted from the community breast pain clinics (CBPCs), BCDCs, patient-reported outcome measures, clinic costs, family history data and staff interviews.Results Breast cancer incidence within the cohort of patients with a full 12-month follow-up period was shown to be 3.7 per 1000 patients, below the population estimates in the literature. There was no delay to care for those who were diagnosed with breast cancer after attending a CBPC. The clinics were found to be cost-beneficial, with a cost-benefit ratio of 1.26 in year 1, 1.40 in year 2 and 1.56 in year 3. The pathway was positively received by patients, with 98.7% indicating that they would recommend the service.Conclusion Following on from previous audits and analysis of the EMBPP pathway, this national evaluation has shown that CBPCs are effective across multiple Cancer Alliances, National Health Service (NHS) Trusts and demographics. The CBPC offers a positive patient experience and is cost-beneficial and safe, with no evidence of a delay to care for the patients.https://bmjopenquality.bmj.com/content/14/3/e003363.full
spellingShingle John Robertson
Emily Griffiths
Thilan Bartholomeuz
Veronica Rogers
Mark Sibbering
Kevin Clifton
Izaak Gilchrist
Transforming care with community breast pain clinics: a validated innovative solution benefitting patients and the healthcare system
BMJ Open Quality
title Transforming care with community breast pain clinics: a validated innovative solution benefitting patients and the healthcare system
title_full Transforming care with community breast pain clinics: a validated innovative solution benefitting patients and the healthcare system
title_fullStr Transforming care with community breast pain clinics: a validated innovative solution benefitting patients and the healthcare system
title_full_unstemmed Transforming care with community breast pain clinics: a validated innovative solution benefitting patients and the healthcare system
title_short Transforming care with community breast pain clinics: a validated innovative solution benefitting patients and the healthcare system
title_sort transforming care with community breast pain clinics a validated innovative solution benefitting patients and the healthcare system
url https://bmjopenquality.bmj.com/content/14/3/e003363.full
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