Audit of a radiographer/nurse-led family history breast cancer clinic

Following the publication of National Institute of Clinical Excellence (NICE) guidelines for familial breast cancer [1], we implemented nurse-led and radiographer-led family history clinics. These replaced a formerly ad hoc system of general practitioner mammogram requests and referrals to the surgical breast clinic.

At the clinic, women were assessed as to their level of increased risk of breast cancer by a detailed family history. They were taught breast self-examination and were put onto appropriate mammography surveillance when indicated or were reassured and discharged.

The majority of referrals were from general practitioners – 62% of women were found to be in the high (23%) and moderate (39%) risk categories. Thirty-eight per cent of patients were found to be at population risk (24%) or were inappropriate referrals.

In conclusion: (1) nurse/radiographer-led family history clinics are effective and an efficient use of resources; (2) there is a high degree of client satisfaction; and (3) there are a significant number of referrals that were not indicated according to NICE guidelines, and action is required to address this issue.