Optimizing Access to Same-Day Breast Biopsy: Factors Associated With Same-Day Procedure Scheduling After Program Standardization

Objective: To assess factors associated with offering patients same-day procedures after 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 March 20, 2024, to June 3, 2024. 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 ± 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 < .001) and ultrasound-guided biopsy (P = .027). Time to biopsy was not significantly different across race or ethnicity. On univariable analysis, patients had higher likelihood of being offered an add-on procedure for ultrasound-guided aspirations (P < .001) and fluid collections (seroma or abscess; P < .001), as well as for BI-RADS 5 final assessment (P < .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.