How can the prevalent round recall rate be reduced?

Introduction

The prevalent round recall rate is higher than the incident recall rate. Implementation of age extension will lead to two prevalent rounds and with this increased clinical and financial pressure on screening units. Any processes that help reduce the recall rate will be of benefit to screening units.

Methods

Retrospective data were collected from April 2008 to March 2009 of prevalent round ladies recalled to assessment clinics. The data recorded included reason for recall, imaging findings and needle test results.

Results

A total of 7,627 women were invited for screening in April 2008 to March 2009, of which 5,341 attended. Four hundred and eighty-one ladies were recalled to assessment; 451/481 of the packets available were reviewed. Forty cancers were identified in 39 patients. All cases of malignancy were coded as RU, RS or RM at the time of film reading. Thirty-two patients were recalled for both sides, four patients recalled for two lesions within the same breast. Nineteen patients were clinical recalls (BA). All solitary RB masses thought to be benign at the time of film reading proved to be benign (91/215 masses). Ten cases recalled for bilateral RB masses were benign. Thirty-six out of 140 asymmetries thought to be benign at the time of film reading were benign.

Conclusions

The recall rate may be reduced in the prevalent round by not recalling solitary RB masses, bilateral RB masses, and asymmetry that appears physiological/benign on two views. In this unit this would have reduced the recall rate without adversely affecting the cancer detection rate.