Evaluation of a one-stop breast lump clinic: a randomized controlled trial

This randomized controlled trial compared the impact on patients (n = 791) of a one-stop clinic providing same-day diagnosis with a conventional system involving two appointments and a delay before results are available. Semi-structured interviews at first clinic attendance and postal questionnaires completed 6 days and 8 weeks later assessed psychological reactions. Six days after first clinic attendance the one-stop group showed significantly lower levels of anxiety (P < 0.05). However, the sub-group who had breast cancer had become more distressed in both groups, more so in the one-stop group. Eight weeks later, women receiving a speedier diagnosis of cancer reported higher levels of depression than women given this diagnosis in the two-stop system (P < 0.05). Same-day diagnosis appears to reduce psychological distress for the 90% of clinic attenders diagnosed with a benign lump. Nevertheless, it may have a detrimental effect on women diagnosed with cancer. The psychological care of these women needs particular consideration as the availability of same-day diagnosis increases.