Introduction: On the 11th of March 2020 the World Health Organisation (WHO) announced that the COVID-19 outbreak had reached pandemic levels. Over 2 million people in the UK were identified as clinically extremely vulnerable and advised to shield. Breast cancer services had to adapt to balance the risk of delayed breast cancer treatment with the risk of exposure to COVID 19.
Methods: The breast unit at The Countess of Chester Hospital introduced a triple assessment clinic exclusively for shielding patients aiming to ensure equitable safe provision for all. Changes involved the use of personal protective equipment, reduced clinic numbers and departmental deep clean prior to each clinic. During a 'shield clinic' there was no additional activity in the department and a one-way patient flow system was implemented.
Results: During the shielding period a total of 83 two week wait clinically vulnerable patients were referred. The age range was 35 to 87 years of age. 44.58% had malignant pathology and 55.42% found to have benign pathology or normal breast tissue. 16 patients were given empirical endocrine treatment, 31.25% of these patients later went on to have biopsy proven oestrogen receptor negative cancers.
Conclusions: The implementation of a dedicated 'shield clinic' during the COVID pandemic allowed clinically vulnerable patients to access breast cancer services in a reduced risk environment. Initial telephone consultation ensured a face to face appointment was absolutely necessary and reduced contact time in the clinic.