Authors: (including presenting author): :
Ng NM(1), Yu PH(1), Yuen HY(2), Chu ML(2), Ng YS(1)
Affiliation: :
(1) Department of Family Medicine, Pok Oi Hospital (2) Department of Surgery, Pok Oi Hospital
Keyword 1: :
Breast lesions
Keyword 2: :
Primary Health Care
Keyword 3: :
Collaboration clinic
Introduction: :
Breast cancer is the most prevalent malignancy among women worldwide. Enhanced screening programs, increased patient awareness, and advanced imaging have raised breast-related concerns among the public. This surge creates heavy service demand on surgical breast clinics, leading to prolonged wait time and resource constraints. Many cases are non-urgent but require structured follow-up for potential malignancy. To address this, NTWC launched a Family Medicine-Breast Collaboration clinic in September 2025, aiming to optimize triage, reduce waiting time, and allocate resources efficiently.
Objectives: :
To evaluate the effectiveness of the collaborative model in three key areas:
•Reducing patient waiting time
•Maintaining diagnostic safety •Reinforcing family physicians’ gatekeeper role in managing probably benign breast lesions
Methodology: :
Standardized triage criteria and workflows were established. Eligible patients included those with BIRADS 3 lesions, incidental low-to-intermediate risk breast findings on non-breast imaging, and biopsy-confirmed benign BIRADS 4A lesions. Family physicians conducted comprehensive assessments and management at collaboration clinic, with robust support from surgery. Those with BIRADS ≥ 4 or new symptoms (e.g., nipple discharge, palpable lumps) were referred back to Surgery. A retrospective analysis of patients enrolled between September 1 and November 30, 2025, was conducted.
Result & Outcome: :
A total of 143 patients were enrolled. The primary referral reasons included BIRADS 3 lesions (58.7%), incidental findings on non-breast imaging (39.9%), and benign BIRADS 4A lesions (1.4%), with most patients (46.9%) referred from the SOPD. The average waiting time for the first consultation significantly decreased from 83 weeks to 9 weeks (P< 0.001). Among the 49 patients with available mammogram / ultrasound results, 49.0% were classified as BIRADS 3, 30.6% as BIRADS 4, and 20.4% as BIRADS 2 (benign) lesions. The majority of patients (69.9%) were managed with follow-up in collaboration clinics, while 23.8% were referred to surgery and 6.3% were closed. Among those referred back to surgery, the most common reasons were BIRADS 4 lesions (47.0%) and the presence of a palpable mass (44.1%).Conclusion: The innovative collaborative model effectively manages non-urgent breast cases in primary care while maintaining diagnostic safety by early detecting conditions that require timely surgical intervention. This approach significantly reduces patients’ waiting time, eases pressure on surgical teams, and strengthens family physicians’ gatekeeper role.
