Introduction: The aim of this audit was to compare activity at our institution during the first pandemic peak with the same time period in 2019.
Methods: We compared breast one-stop clinic and surgical activity from 01/04/2020-01/07/2020 to the 2019 period. A pathway was developed for one-stop clinics whereby patients had a telephone triage to stratify their hospital appointment according to risk. A surgical pathway was developed whereby patients isolated for 14 days before surgery and had a COVID-19 swab three days before surgery.
Results: Audit approval was gained. 1027 patients were referred to the one-stop clinic, compared to 1933 the year before (47% reduction). 67 patients were diagnosed with breast cancer, 61 (91%) had no delay in diagnosis, for the 6 that did, the delay was 37.5 days (range=17-44). 333 breast cancer surgery operations were performed, compared to 412 the previous year (19% reduction). In 2020 the unplanned re-admissions were 2 (0.6%) compared to 9 (2.1%) in 2019. Unplanned returns to theatre were 4 (1.2%) and 8 (1.9%) respectively. All surgical patients were contacted 28 days after discharge and no-one was diagnosed with COVID-19. 75 patients had their surgery deferred, all of whom have now had appropriate management instigated.
Conclusions: Introduction of these clinic and surgical pathways allowed continuation of services during the pandemic. The pathways were safe, with low surgical re-admission/theatre return rates and no patient developed COVID-19 within 28 days. 91% of patients did not experience a delay in diagnosis. The delays are likely to be non-clinically significant.