{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:28:55Z","timestamp":1787315335582,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Research indicates that breast pain as the sole symptom has no association with breast cancer. However, patients with breast pain only are often referred onto urgent breast cancer diagnostic pathways, leading to unnecessary anxiety and overutilisation of secondary health care services. The novel community breast pain clinic (CBPC) service in the UK aims to improve patient care while providing system\u2010wide improvements for patients with breast pain, patients who have \u2018red flag\u2019 symptoms, as well as being cost\u2010effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim and Objectives<\/jats:title>\n                    <jats:p>This study seeks to evaluate and assess the impact of the CBPC on patient care, experience, and healthcare system improvements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Quantitative and qualitative analysis of CBPC was undertaken using data from CBPC based on a core data set designed by the programme team, secondary care follow\u2010up data, Patient Reported Outcomes Measure (PROMs) data and family history data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The CBPC was well\u2010received by patients with 98.5% recommending the service. Additionally, health economic analysis indicated a cost benefit ratio of 1.23 in year 1, indicating a positive return on investment. Breast cancer incidence within the cohort was estimated at 3.2 per 1000, in line with population estimates in the literature. For those with a breast cancer diagnosis, there is no evidence of care delays or missed diagnoses via the service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The CBPC offers significant benefits in patient experience and value for money, with no evidence of reducing patient safety. The impacts of the clinics appear to be reproducible across all five centres in the East Midlands (a population of 5.5 million). Recommendations on further assessment on optimal staff mix and clinic cost mechanisms should be considered to maximise benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70150","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T10:14:05Z","timestamp":1749550445000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["East Midlands Breast Pain Pathway: An Evaluation of Community Breast Pain Clinics Across the East Midlands Cancer Alliance"],"prefix":"10.1111","volume":"31","author":[{"given":"John F. R.","family":"Robertson","sequence":"first","affiliation":[{"name":"Royal Derby Hospital University Hospitals of Derby and Burton Foundation Trust Derby UK"},{"name":"Department of Breast Surgery University of Nottingham, Graduate Entry Medical School, Royal Derby Hospital Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilan","family":"Bartholomeuz","sequence":"additional","affiliation":[{"name":"Mid\u2010Nottinghamshire Place Based Partnership, Sir John Robinson House, Sir John Robinson Way, Arnold Nottingham England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Rogers","sequence":"additional","affiliation":[{"name":"Royal Derby Hospital University Hospitals of Derby and Burton Foundation Trust Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Clifton","sequence":"additional","affiliation":[{"name":"Chesterfield Royal Hospital NHS Foundation Trust Chesterfield"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2280-6627","authenticated-orcid":false,"given":"Lucy","family":"Pirkle","sequence":"additional","affiliation":[{"name":"Edge Health Ltd London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Stafford","sequence":"additional","affiliation":[{"name":"Royal Derby Hospital University Hospitals of Derby and Burton Foundation Trust Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Ryan","sequence":"additional","affiliation":[{"name":"East Midlands Cancer Alliance, County Hall Leicestershire England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Mark Sibbering","sequence":"additional","affiliation":[{"name":"Royal Derby Hospital University Hospitals of Derby and Burton Foundation Trust Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12262-013-0813-8"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7171.1492"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-130-8-199904200-00005"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2002.21.5.521"},{"key":"e_1_2_8_6_1","first-page":"598","article-title":"Ne.Gative Predictive Value of Mammography and Sonography in Mastalgia With Ne.Gative Physical Findings","volume":"59","author":"Masroor I.","year":"2009","journal-title":"JPMA. 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Faster diagnostic pathways: implementing a timed breast cancer diagnostic pathway: guidance for local health and social care systems 2024b https:\/\/www.england.nhs.uk\/long-read\/faster-diagnostic-pathways-implementing-a-timed-breast-cancer-diagnostic-pathway-guidance-for-local-health-and-social-care-systems\/[Accessed: 05\/03\/2024]."},{"key":"e_1_2_8_16_1","unstructured":"British Society of Breast Radiology (BSBR) BSBR Update On Breast Pain February 2023 https:\/\/breastradiology.org\/media\/1294\/bsbr-update-on-breast-pain-feb-23.pdf. Accessed: 18\/07\/2023."},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq-2021-001634"},{"key":"e_1_2_8_18_1","unstructured":"National Breast Imaging Academy New mammography workforce model boosts breast screening programme 5 January 2023 https:\/\/nationalbreastimagingacademy.org\/news\/new-mammography-workforce-model-boosts-breast-screening-programme\/. 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