title: Impact of age extension to include 47-49 year old women on the workload of the surgical department of a single Breast Cancer Screening Unit--The first non-randomized experience in UK.
abstract: BACKGROUND
  The aim of this study was to assess the impact on the surgical unit of the first year (prevalence screening) of non-randomized invitations to 47-49 year old women for breast screening, from a single breast screening unit.
  
  
  METHODS
  All women undergoing surgery in the age group 47-49 years, referred via screening were identified and the increased workload analysed.
  
  
  RESULTS
  4250 (76%) women were screened of the 5624 invited. 396 women were recalled, of whom 88 (22%) underwent a core biopsy. 32 patients required surgical intervention. 20 patients (62.5%) were confirmed to have either DCIS (6 patients) or invasive malignancy (14 patients). They required 37 theatres attendances requiring 42 operations. 16 wire guided wide local excisions (14 with sentinel node biopsy), 7 mastectomies (2 with sentinel node biopsy; 1 with axillary clearance), 6 margin re-excisions, 1 tissue expander insertion and removal, 3 Latissimus Dorsi with implant and 2 TRAM reconstructions. Other cases include haematoma drainage, scar revisions and nipple reconstructions. This group generated 100 NHS surgical outpatient consultations (78 breast and 22 plastic surgery). 12 patients (37.5%) underwent surgery for a B3 vacuum result; 10 underwent wire guided and 1 ultrasound guided skin marked excision biopsy. 1 patient was treated privately. This group generated 25 NHS surgical outpatients consultations.
  
  
  CONCLUSIONS
  This study highlights the impact of the 47-49 year age extension within the breast screening programme on the workload of the surgical department of a UK Breast Cancer Screening Unit offering non-randomized invitations. The study will inform other surgical units of expected workload when age extension is fully implemented.
authors.affiliation: Department of Breast & General Surgery, Surgery Directorate 1, Royal Devon and Exeter NHS Foundation Trust, UK. arun.ariyarathenam@nhs.net
authors.forename: A V
authors.initials: AV
authors.lastname: Ariyarathenam
authors.forename: R
authors.initials: R
authors.lastname: Currie
authors.forename: M J
authors.initials: MJ
authors.lastname: Cooper
authors.forename: D J
authors.initials: DJ
authors.lastname: Ferguson
authors.forename: J M
authors.initials: JM
authors.lastname: Dunn
mesh_terms: D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008408:Mastectomy; D008875:Middle Aged; D012189:Retrospective Studies; D013503:Surgery Department, Hospital / Q000458:organization & administration*; D006113:United Kingdom / Q000453:epidemiology; D016526:Workload / Q000706:statistics & numerical data*
keywords: Breast cancer; Screening