‘Fast-tracking’ cancer referrals: application for periocular basal cell carcinoma

Bhatnagar, A.; Mohamad, S.; Sandramouli, S.
April 2006
Eye;Apr2006, Vol. 20 Issue 4, p428
Academic Journal
AimTo study the feasibility of a modified fast-track protocol for periocular basal cell carcinoma (BCC).MethodsA modified protocol was set up with an aim to examine all periocular BCCs within 6 weeks of referral to our oculoplastic clinic. An audit of this protocol was performed over a 2-year period.ResultsA total of 65 patients were referred as a ‘possible BCC’ over the 2-year period. In all, 32 of these patients were referred by dermatologists (49%), followed by fellow consultant ophthalmologists (20 patients, 31%) and general practitioners (11 patients, 17%). The clinical suspicion in the oculoplastic clinic agreed with the referral diagnosis in 71% (46 of the 65) of patients. This figure was particularly high for referrals from dermatologists (84%). In all, 44 out of the 46 ‘clinically suspected BCC’ underwent surgical excision. Histopathology confirmed BCC in 39 of these 44 patients, a diagnostic accuracy of 89%. Among the subgroup of patients referred by the dermatologists, the largest source of referrals, 24 out of 30 patients that underwent surgical excision had histologically proven BCC; a diagnostic accuracy of 80%.ConclusionOur study shows that the modified fast-track protocol for periocular BCCs is practical and feasible. Such a practice is highly desirable since it prevents a long wait for patients who are aware of a possible malignant periocular lesion.Eye (2006) 20, 428–430. doi:10.1038/sj.eye.6701894; published online 6 May 2005


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