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European Journal of Surgical Oncology ; 48(5):e214, 2022.
Article in English | EMBASE | ID: covidwho-1859513


Introduction: Breast Incidentalomas occur as an unexpected abnormality demonstrated on imaging performed for unrelated symptoms. Pre-COVID19 pandemic management involved urgent referrals for initial breast team evaluation. Clinical encounters occurred prior to the Multi-Disciplinary Team meeting (MDT). COVID-19 restrictions necessitated streamlining and optimising service provision with clinically appropriate encounters. Our aim was to re-audit (SU-CA-21-22-068) findings and management of breast incidentalomas during the pandemic. Methods: Pre-pandemic analysis of practice (November 2019 - January 2020) led us to the intervention of all referrals straight to MDT without an unnecessary prior clinical encounter, with secondary planned investigations and clinical assessment thereafter. Completion of audit loop and analysis included referral information, MDT outcome, imaging, and clinical correspondence with descriptive analysis. Results: Post-intervention 61 patients were referred to the MDT over an 18-month period (February 2020 - October 2021). 90% of patients were referred following CT scans. Median age 71 (range 32-93), 38% of patients had no additional breast imaging and 74% of patients did not require a tissue biopsy. 15% (n=9) were diagnosed with new breast cancer, 36% were new benign, with 34% already known lesions. 16% of patients required no further intervention. Conclusion: 15% of incidentalomas were diagnosed as malignancies, compared to local 3-4% from one stop clinics. Prompt referral to MDT accelerates triple assessment and tissue diagnosis. Streamlining of patient care optimised appropriate clinical encounters for vulnerable patients. Early senior radiological assessment at the MDT of incidentalomas during COVID-19 provided confirmation of benign features and therefore no further intervention and reassurance for 16% of patients.