News Release

Are one stop breast clinics justified?

Peer-Reviewed Publication

BMJ

Costs and benefits of a one stop clinic compared with a dedicated breast clinic: randomised controlled trial BMJ Volume 324, pp 507-10

One stop clinics for assessing women with suspected breast cancer may not be as cost effective as previously thought, according to a study in this week’s BMJ.

Women aged 35 or over who were referred to hospital with a breast lump were randomly allocated to attend either a dedicated breast clinic or a one stop clinic. The costs and benefits of each clinic were measured and compared.

Compared to women attending the dedicated clinic, those attending the one stop clinic were less anxious 24 hours after their visit but not at 3 weeks or 3 months after diagnosis. A one stop policy cost £32 more per patient. The costs saved by reducing the number of visits are more than offset by the staff costs of same day reporting of diagnostic tests, say the authors.

Benefits of one stop clinics are, in the main, short term, and may not justify the added costs, they conclude.

Before the one stop breast clinics that already exist are dismantled on the basis of these results, several issues need to be considered, writes Michael Dixon in an accompanying commentary. They should not yet be abandoned, but their supporters do need to show that if they see more patients per clinic and use a more selective testing policy than in this study, the benefits are not outweighed by the costs, he concludes.

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