"Take Home Points:

1.Patients receiving biopsy recommendations earlier in the day and patients undergoing ultrasound-guided biopsy (as compared to stereotactic-guided biopsy) were significantly more likely to be offered a same-day biopsy.

2.Radiologists were more likely to create “add-on” procedure slots for patients with BI-RADS 5 assessments, abscesses or seromas, or when ultrasound-guided aspiration was required.

3.Optimizing patient workflow and scheduling logistics in same-day breast biopsy programs may help reduce time to diagnosis, particularly for patients facing barriers to timely care.

Abstract:

Objective

To assess factors associated with offering patients same-day procedures following implementation of a standardized same-day procedure program.

Methods

This quality improvement study reviewed data from all patients at our single-site academic institution who were recommended for a breast procedure from 3/20/24-6/3/24. Patient and diagnostic examination characteristics, and time between diagnostic examination and procedure appointments, were recorded. Enacting “add-on” procedures, defined as the creation of an additional same-day procedure slot through overbooking, was also recorded. Associations between patient sociodemographic characteristics and diagnostic examination characteristics with same-day procedures logistics were evaluated using a nominal logistic model.

Results

Of 315 patients (mean age 53.8 years ± 16.4 years), 168 (53%) were offered a same-day biopsy appointment based on procedure availability. Another 35 patients (11%) were offered an “add-on” procedure; 8 (3%) were for urgent BI-RADS 2 findings (such as abscess). On multivariable analysis, factors associated with increased likelihood of being offered same-day biopsy appointment were morning recommendation time (p < 0.001) and ultrasound-guided biopsy (p = 0.027). Time to biopsy was not significantly different across race/ethnicity. On univariable analysis, patients had higher likelihood of being offered an “add-on” procedure for ultrasound-guided aspirations (p < 0.001) and fluid collections (seroma/abscess; p < 0.001), as well as for BI-RADS 5 final assessment (p < 0.001).

Discussion

Scheduling diagnostic workups should be considered earlier in the day at institutions that offer same-day procedure services, particularly for cases involving highly suspicious lesions, abscesses or seromas, or patients with psychosocial factors that could otherwise delay care.

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