[One day diagnosis for breast lesions: Medical and psychological assessment--EVADIASEIN study].
BACKGROUND
Breast cancer is the most frequent feminine cancer in France and its incidence increases steadily. The time of access to medical care is an indicator of the quality of the treatments recommended by the Plan Cancer 2009-2013, as it influences the diagnosis and reduces psychological morbidity during the pre-diagnosis phase. The one-day diagnosis is a recently initiated concept, which offers to get the results of the biopsy on the day it is performed and facilitates the setting-up of therapeutic care with the surgeon met during the one-day medical consultations. The aim of this study is to evaluate the satisfaction of patients who benefited from a one-day breast lesion diagnosis, as well as confirm the decrease of time of access to medical treatment.


METHODS
This is an observational, non-interventional and single-centre study based on 27 patients who benefited from one-day breast lesions diagnosis over two years. The patients were only included who had a classified lesion ACR 4 or 5 and visible in the ultrasound. We analyzed the histological concordance between the biopsy and the definitive histology, the time of access to medical care, and the therapeutic treatments We analyzed the psychological impact of such an organization by sending to the patients a questionnaire including the Psychological Consequence Questionnaire (PCQ) and the Breast Cancer Anxiety Indicator (BCA) allowing to estimate the anxiety generated by the pre-diagnostic phase, the DC-Sat allowing to estimate the satisfaction of the consultation of announcement, as well as the same day diagnosis benefit.


RESULTS
The patients were 59.8 years old in average [33-87]. The average time between the date of the mammography and the one-day diagnosis consultation (including the biopsy) was 15.0 days [0-60]. Fifty-seven percent of the patients considered this time as short. The average time between the biopsy date and the start of the treatment was 15.9 days [4-30]. The one-day diagnosis took an average of 1.6 days [1-5]. The results of the PCQ showed an important emotional impact during the diagnosis phase, and the average BCA score reached an average of 3.9 on a scale of 5. However, the patients were very satisfied with the diagnosis consultation with an average of 8.7 on a scale of 10, and 95% think the one-day diagnosis is beneficial to the patients.


CONCLUSIONS
This study shows that the one-day breast-damage diagnosis enables to improve the time of access to care, and meets the current recommendations. Even though faster access to treatment does not reduce the psychological morbidity of awaiting diagnosis, the patients express their satisfaction and find the rapidity of the pre-diagnosis phase beneficial.


CONCLUSIONS
In view of this study, the one-day breast-damage diagnosis appears to be a quality feature in the process of access to care and treatment of the patients.
Service de gynécologie obstétrique, hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France.
A
A
Berman
Service de anatomo-pathologie, hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France.
B
B
Teig
Service de médecine interne, hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France.
M
M
Duracinsky
Service de radiologie, hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France.
M
M
Gayet
Service de radiologie, hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France.
M-F
MF
Bellin
Service de anatomo-pathologie, hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France.
C
C
Guettier
Service de gynécologie obstétrique, hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France; Université Paris-Sud, 63, rue Gabriel-Péri, 94270 Le-Kremlin-Bicêtre, France; Inserm U1018, CESP « reproduction et développement de l'enfant », 82, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France.
H
H
Fernandez
Service de gynécologie obstétrique, hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France; Laboratoire de physique des interfaces et des couches minces, école polytechnique, 91128 Palaiseau, France. Electronic address: andre.nazac@bct.aphp.fr.
A
A
Nazac
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D013997:Time Factors
Anxiety; Anxiété; Biopsie; Biopsy; Breast cancer; Cancer du sein; Diagnostic en un jour; Délai de prise en charge; One-day diagnosis; Processing time