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BREAST CANCER CLINIC, ST. ANN'S HOSPITAL
Introduction
Mr. Abel, Consultant Surgeon at Prince of Wales's and St. Ann's Hospitals, asked Dr. Patton, Medical Officer of
Health, London Borough of Haringey, to co-operate with him in a scheme to examine 1,000 women annually to
try to achieve earlier detection of Breast Cancer. The examination was to be by palpation only. The scheme and
its history and results over five years are described. In 1967 the cervical cytology scheme was also gaining
momentum and so the first 1,000 women over 35 years who applied for cervical cytology, thereby showing their
interest in taking advantage of cancer detection schemes, were invited to join the Breast Cancer Screening
Clinic.
General arrangements and clerical work
In 1968 it was decided to hold sessions twice a week during July. A main session was held on Tuesdays attended
by two doctors from the Local Authority and two from the hospital. Approximately 160 patients were
appointed to these sessions. A further 40 patients were appointed to a Thursday morning clinic where they were
seen by Mr. Abel's registrar and houseman together with some other types of outpatients.
The same arrangements were made in 1969 but the Thursday session was never satisfactory and it was dropped
from 1970. The appointments were in batches between 9.30 am and 11.30 am and as we became more practised
in the organisation of the clinic it was not too difficult to cope with 200 patients (approximately) per session
once a week.
With so many women coming and going there was inevitably some waiting and queuing. Some complained but
most were so appreciative of the opportunity to participate that they put up with minor inconvenience.
The clerical work prior to the sessions was quite arduous. The work involved making all the appointments and
giving information. One administrative officer was in charge of the work. She prepared the list of those
expected at the session in readiness for the volunteer clerical staff who covered the actual sessions.
None of the administrative work was done by the hospital. Patients were told on their appointment cards to
contact the Town Hall if necessary.
Staff and Premises
The screening clinics were held at St. Ann's General Hospital, Tottenham, in an adapted ward where a reception
area was set up near the door with two volunteer clerks in attendance. There were six curtained cubicles each
with an examination couch in which all dressing and undressing, as well as the examinations, were done.
Doctors
All the patients were examined by a doctor and the aim was to have four doctors working at each session, two
from the hospital and two from the Local Authority.
The Consultant Surgeon (Mr. K. Abel) was present at (almost) all the sessions.
Nurses
The hospital Outpatient Sister was in charge and usually there were three nurses on duty. They organised the
patients on and off the couches, helped at cyst aspirations, chaperoned and made outpatient appointments when
necessary. There was one volunteer nurse from St. John's Ambulance Brigade who attended all the sessions.
She was a member of the local Women's Cancer Control Campaign who provided all the volunteers.
Clerks
Two volunteers received the patients as they came in, accepted their appointment cards and looked out the
record cards from the file. They checked off the names on the lists supplied by the Local Authority administrative
staff. They helped to record non-attenders at the end of the session and generally kept the cards in order. They
also distributed health education leaflets on breast self-examination and other information on cancer prevention.
Attendances
1968—959 patients were sent appointments
814 attended
1969—1,021 patients were sent appointments
730 attended
The 1,021 were made up of all the original 959 plus others who asked to join.
In an attempt to cut down on the clerical work appointments were given to patients for the
following year when they attended in 1969.
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