Call for review of two-week breast cancer referral rule

The ‘two-week’ rule for breast cancer referrals must be reviewed, say UK experts.

They are concerned that pressure to refer a patient with breast cancer to a specialist within two weeks of a GP appointment is leading to delayed care for patients referred as ‘routine’ who are found to have breast cancer.

More than one in four patients found to have breast cancer are being referred as ‘routine’, putting them on waiting lists that can be as long as 30 days.

The findings come from a study of the outcomes of primary care referrals to a breast cancer clinic in Bristol between 1999, when the two-week rule was introduced, and 2005.

During this time, the number of annual routine referrals decreased by 24 per cent and two-week referrals increased by 42 per cent.

Over the seven years, the number of patients diagnosed with cancer in the two-week group fell from 12.8 per cent to 7.7 per cent. But the number of cancers detected in the routine group increased from 2.5 per cent to 5.3 per cent.

In all, 27 per cent of patients diagnosed with breast cancer in 2005 were referred as routine, while 90 per cent of two-week referrals were benign.

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