Breast disease diagnostic ability of nurse practitioners and surgeons.
OBJECTIVE
This paper is a report of a study to compare history-taking and breast and axillary examination skills of nurse practitioners and surgeons.


BACKGROUND
In the United Kingdom, patients referred by their general practitioners with suspected breast cancer should be seen within 2 weeks by a specialist. As a result of the European Working Time Directive there has been a reduction in junior doctors' working hours within the European Union. This makes such targets harder to achieve and risks delays in patient assessment and diagnosis. Trained nurse practitioners can perform an important role in assessing new patients in breast clinics to ensure that they are seen expeditiously. Nurse practitioners' competence assessing patients with breast disease needs to be objectively demonstrated.


METHODS
Between 1st March 2007 and 31st March 2008 patients referred to a symptomatic breast disease clinic were seen by a single nurse practitioner and a single consultant surgeon. Findings were recorded on a standardised pro forma and compared using one-way analysis of variance.


RESULTS
Assessments were recorded for 128 patients. No abnormality was found in 41% of patients but nine (7%) had breast cancer. There was no evidence of a statistically significant mismatch in scoring between the nurse practitioner and consultant surgeon. Thirty-seven lumps were identified in 35 patients. There was no difference in mammography requests from the nurse practitioner and surgeon.


CONCLUSIONS
The diagnostic accuracy of a nurse practitioner compares favourably with that of a consultant surgeon.
Osborn
Gary David
GD
Department of General Surgery, Royal Glamorgan Hospital, Llantrisant, UK. garyosborn2@aol.com
Jones
Maria
M
Gower-Thomas
Kate
K
Vaughan-Williams
Eifion
E
D000328:Adult; D000368:Aged; D001706:Biopsy; D001941:Breast Diseases / Q000175:diagnosis*; D002983:Clinical Competence; D005260:Female; D013502:General Surgery; D006769:Hospitals, General; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008485:Medical Audit; D008875:Middle Aged; D009722:Nurse Practitioners; D024802:Nurse's Role; D057184:Practice Patterns, Nurses'; D012680:Sensitivity and Specificity; D014852:Wales; D055815:Young Adult