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School of Health and Related Research (ScHARR), University of Sheffield. Clinical Guidelines for the Classification and Care of Women at Risk of Familial Breast Cancer in Primary, Secondary and Tertiary Care [Internet]. Sheffield (UK): University of Sheffield; 2004 May. (NICE Clinical Guidelines, No. 14.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of Clinical Guidelines for the Classification and Care of Women at Risk of Familial Breast Cancer in Primary, Secondary and Tertiary Care

Clinical Guidelines for the Classification and Care of Women at Risk of Familial Breast Cancer in Primary, Secondary and Tertiary Care [Internet].

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9Audit criteria

The measures that could be used as a basis for audit are in the table below.

CriterionStandardExceptionDefinition of terms
Standard written information should be developed for use in primary, secondary and tertiary care100% of centres to provide this informationNilWritten information that will provide consistent advice to women, including risk and breast awareness information, lifestyle advice etc
Local protocols should be developed with clear referral mechanisms between primary, secondary and tertiary care and with appropriate facilities100% of organisations should have local protocolsNil
Psychological services available in secondary care100% of secondary care have a named individual providing psychological supportNil
Information should be provided about the potential advantages and disadvantages of mammographic surveillance100% of women who are offered mammographic surveillanceNilInformation includes written information and discussion on
  • Reduced sensitivity in younger breasts
  • Radiation risks
  • Possible psychological impact of recall visit
Risk-reducing surgery should be managed by a multidisciplinary team100% women who have risk reducing surgeryRisk-reducing surgery refers to bilateral mastectomy and oophorectomy
A multidisciplinary team should include:
  • facilities to verify family history and clinical genetic risk assessment
  • mammography before surgery
  • psychological assessment and counselling
  • information about support groups oncoplastic/breast reconstructive skills

Calculation of compliance

Compliance (%) with each measure described in the table above is calculated as follows.

Number of patients whose care is consistent with the criterion plus
number of patients who meet any exception listed × 100
______________________________________________________________
Number of patients to whom the measure applies

Clinicians should review the findings of measurement, identify whether practice can be improved, agree on a plan to achieve any desired improvement and repeat the measurement of actual practice to confirm that the desired improvement is being achieved.

Copyright © 2004, School of Health and Related Research (ScHARR), University of Sheffield.
Bookshelf ID: NBK65444
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