NHS Information Authority

Data Standards Programme

This DSCN sets out the changes to the NHS Data Dictionary & Manual necessary to support the revised KC62 return.

REFERRAL FOR BREAST ASSESSMENT

Attributes of this Class are:

K		REFERRAL NUMBER
	O	BREAST ASSESSMENT DATE
		recorded when patient attends for assessment
	O	BREAST ASSESSMENT FINAL OUTCOME
		recorded when assessment completed
		BREAST ASSESSMENT FIRST APPOINTMENT DATE

REFERRAL FOR BREAST TREATMENT

Attributes of this Class are:

K		REFERRAL NUMBER
	O	BENIGN THERAPEUTIC OPERATION
	O	CANCER DETECTED BY SURGERY

REFERRAL FOR SCREENING TEST

Attributes of this Class are:

K		REFERRAL NUMBER
		FIRST TEST DATE OFFERED
		SCREENING REFERRAL DATE
		SCREENING REFERRAL SOURCE

REQUEST FOR PATHOLOGY INVESTIGATION

Attributes of this Class are:

	O	BIOPSY REFERRAL OUTCOME
	O	CANCER HISTOLOGICAL TYPE
		breast cancer only
	O	CERVICAL SMEAR EXAMINED DATE
	O	CYTOLOGY RESULT TYPE
		cervical screening only
	O	CYTOLOGY SMEAR REASON
	O	INVASIVE CANCER SPECIAL TYPE INDICATOR
		breast cancer only
	O	INVASIVE LESION SIZE
		if applicable as a result of biopsy for invasive breast cancers
	O	LYMPH NODE STATUS
		breast cancer only
		PATHOLOGY SPECIALTY
	O	SMEAR INFECTION TYPE
	O	SMEAR REFERRAL NATURE
		Cervical screening only
	O	SMEAR SOURCE TYPE

SCREENING PROGRAMME

Attributes of this Class are:

	O	BREAST SCREENING INCIDENT VIEW NUMBER
		breast screening only
	O	BREAST SCREENING PREVALENT VIEW NUMBER
		breast screening only
	O	BREAST SCREENING READING TYPE
		breast screening only
	O	CERVICAL SCREENING RECALL INTERVAL
		applies to cervical screening programmes only
		cervical screening only
		SCREENING CONDITION OR DISEASE

SCREENING TEST

Attributes of this Class are:

K		TEST NUMBER
	O	BREAST CANCER SCREENING TEST OUTCOME
		breast screening only
	O	CYTOLOGY RESULT TYPE
	O	CYTOLOGY SCREENING ACTION TYPE
		LOCATION TYPE
	O	NON ROUTINE RECALL INTERVAL
		OPPORTUNISTIC SCREENING INDICATOR
		cervical screening only
	O	PATHOLOGY RESULT REPORTED DATE
	O	RESULT SENT DIRECT
		cervical cytology only
		SCREENED WHILE SUSPENDED INDICATOR
		cervical screening only
	O	SCREENING RESULT DATE
	O	SCREENING RESULT SENT DATE
		cervical cytology result sent by HEALTH AUTHORITY
		SCREENING TEST DATE
	O	SCREENING TEST RESULT
		TEST DATE OFFERED
		breast screening only

SCREENING TEST INVITATION

Attributes of this Class are:

K		INVITED FOR SCREENING DATE
		ATTENDED OR DID NOT ATTEND
		INVITATION TYPE
	O	TEST DATE OFFERED
		breast screening only

BENIGN THERAPEUTIC OPERATION

BENIGN THERAPEUTIC OPERATION

An indicator of whether the REFERRAL FOR BREAST TREATMENT resulted in benign therapeutic surgery.

Classification:

a.	Yes
b.	No

Reference:
Central Return KC62 Adult Screening Programmes - Breast Screening

This attribute is also known by these names:

Context	Alias
plural	BENIGN THERAPEUTIC OPERATIONS

BIOPSY REFERRAL OUTCOME

A code used to reference an outcome of a REFERRAL FOR BIOPSY. For cervical histology, biopsies are taken after a colposcopy has been performed.

For cervical histology for KC61 purposes, the classification is:

a.	Cervical Cancer (including micro-invasive)
b.	Adenocarcinoma in situ
c.	CIN3
d.	CIN2
e.	CIN1
f.	HPV only
g.	No CIN/No HPV
h.	Inadequate biopsy
i.	Colposcopy - Nothing Abnormal Detected (NAD)/no biopsy taken
j.	Results not known by laboratory
k.	Non cervical cancers detected

For cervical histology for KC65 purposes, the classification is:

a.	Cancer (including micro-invasive)
b.	Adenocarcinoma in situ
c.	CIN3
d.	CIN2
e.	CIN1
f.	HPV/cervicitus only
g.	No CIN/No HPV (normal)
h.	Inadequate/unsatisfactory biopsy
i.	Result not known by clinic

For breast cancer screening the classification is: For breast cancer screening for KC62 purposes,the classification is:

a.	Benign or negative
a.	Benign or negative
b.	Inconclusive
b.	Inconclusive
c.	Positive; i.e. cancer detected
c.	Positive; i.e. cancer detected
	i.	non-invasive or possibly micro-invasive
	i.	non-invasice or possibly micro-invasive
	ii.	definitely micro-invasive
	a.	low (DCIS only detected)
	iii.	invasive size not known
	b.	intermediate (DCIS only detected)
	iv.	invasive size known
	c.	high (DCIS only detected)
d.	Biopsy not done or result not yet known

  d.  grade not known (DCIS only detected) ii.definitely micro-invasive   a.  low (DCIS only detected)   b.  intermediate (DCIS only detected)   c.  high (DCIS only detected)   d.  grade not known (DCIS only detected) iii.invasive size not known   a.  Grade I   b.  Grade II   c.  Grade III   d.  grade not known iv.invasive size known   a.  Grade I   b.  Grade II   c.  Grade III   d.  grade not known v.invasive status not known d.Biopsy not done or result not yet know

References:
KC65 - Colposcopy Clinics, Referrals, Treatments and Outcomes
KC61: Pathology Laboratories - Cervical Cytology and Outcome of Gynaecological Referrals
KC62: Adult Screening Programmes - Breast Screening

This attribute is also known by these names:

Context	Alias
plural	BIOPSY REFERRAL OUTCOMES

BREAST ASSESSMENT FIRST APPOINTMENT DATE

BREAST ASSESSMENT FIRST APPOINTMENT DATE

The first date offered to a PERSON for an appointment as a result of a REFERRAL FOR BREAST ASSESSMENT following a SCREENING TEST. This is the first date offered which may not necessarily be the first actual appointment date accepted by the PERSON.

Reference:
Central Return KC62 Adult Screening Programmes - Breast Screening

This attribute is also known by these names:

Context	Alias
plural	BREAST ASSESSMENT FIRST APPOINTMENT DATES

BREAST CANCER SCREENING TEST OUTCOME

The outcome of a SCREENING TEST for breast cancer.

Classification:

a.	Routine recall
b.	Early Recall (Note: NHS Breast Screening Programme policy states that this should not apply)
c.	Referred for assessment
d.	Referred direct to histology

This attribute is also known by these names:

Context	Alias
plural	BREAST CANCER SCREENING TEST OUTCOMES

BREAST CANCER TARGET AGE GROUP

The overall age range of the target population for breast cancer screening programmes. The target screening age range for women specified by the NHS Breast Screening Programme is 50 to 70.

Reference: Central Return KC62 Adult Screening Programmes - Breast Screening

This attribute is also known by these names:

Context	Alias
plural	BREAST CANCER TARGET AGE GROUPS

BREAST SCREENING INCIDENT VIEW NUMBER

BREAST SCREENING INCIDENT VIEW NUMBER

The policy of a SCREENING PROGRAMME of the number of views taken for an incident SCREENING TEST for PERSONS who have previously had a SCREENING TEST.

Classification:

a.	One view; the medio-lateral oblique view
b.	Two views; the media-lateral oblique view and the cranio-caudal view

Reference:
Central Return KC62 Adult Screening Programmes - Breast Screening

This attribute is also known by these names:

Context	Alias
plural	BREAST SCREENING INCIDENT VIEW NUMBERS

BREAST SCREENING PREVALENT VIEW NUMBER

BREAST SCREENING PREVALENT VIEW NUMBER

The policy of a SCREENING PROGRAMME of the number of views taken for a prevalent SCREENING TEST for PERSONS who have not previously had a SCREENING TEST.

Classification:

a.	One view; the medio-lateral oblique view
b.	Two views; the media-lateral oblique view and the cranio-caudal view

Reference:
Central Return KC62 Adult Screening Programmes - Breast Screening

This attribute is also known by these names:

Context	Alias
plural	BREAST SCREENING PREVALENT VIEW NUMBERS

BREAST SCREENING READING TYPE

BREAST SCREENING READING TYPE

This is how a decision to recall a woman for further assessment is made if her screening films show abnormal features.

Classification:

a.	single; a single radiologist reads the films and if recommends assessment, the woman is recalled
b.	recall if one suggests; two radiologists or one radiologist and one specially-trained radiographer read screening films independently and recall if either one of the film readers recommends it
c.	consensus; two radiologists or one radiologist and one specially-trained radiographer read screening films independently and only recall if both the readers recommend it
d.	arbitration; two radiologists or one radiologist and one specially-trained radiographer read screening films independently and for the readers to discuss each case and agree on which women should be recalled
e.	mixed; there is a variety of practices. This may be because different people work different sessions or if there has been a change of protocol during the year. However, it does not mean, for example, that things were done differently for a week or two because a radiologist was off sick.

Reference:
Central Return KC62 Adult Screening Programmes - Breast Screening

This attribute is also known by these names:

Context	Alias
plural	BREAST SCREENING READING TYPES

CANCER HISTOLOGICAL TYPE

CANCER HISTOLOGICAL TYPE

The histological type for a breast cancer.

National Codes:

DN	Ductal (NST)
LP	Lobular
M	Medullary
MP	Mucinous
OM	Other malignant
OP	Other primary cancer
OX	Other (mixed)
TM	Tubular (mixed)
TP	Tubular (pure)

Reference:
Central Return KC62 Adult Screening Programmes - Breast Screening

This attribute is also known by these names:

Context	Alias
plural	CANCER HISTOLOGICAL TYPES

FIRST TEST DATE OFFERED

FIRST TEST DATE OFFERED

The first date for an appointment offered by a screening office for a woman to undergo a SCREENING TEST following a REFERRAL FOR SCREENING TEST. If another date is subsequently offered by a screening office, this first date should not be overwritten.

Reference:
Central Return KC62 Adult Screening Programmes - Breast Screening

This attribute is also known by these names:

Context	Alias
plural	FIRST TEST DATES OFFERED

INVASIVE CANCER SPECIAL TYPE INDICATOR

INVASIVE CANCER SPECIAL TYPE INDICATOR

An indicator of whether or not an invasive breast cancer detected is a special type.

Classification:

a.	special type
b.	not special type

Reference:
Central Return KC62 Adult Screening Programmes - Breast Screening

This attribute is also known by these names:

Context	Alias
plural	INVASIVE CANCER SPECIAL TYPE INDICATORS

LYMPH NODE STATUS

LYMPH NODE STATUS

The status of the lymph node sampled from a woman with suspected breast cancer.

Classification:

a.	lymph node positive
b.	lymph node negative

Reference:
Central Return KC62 Adult Screening Programmes - Breast Screening

This attribute is also known by these names:

Context	Alias
plural	LYMPH NODE STATUSES

TEST DATE OFFERED

The date of the appointment offered by a screening office to a woman to undergo a SCREENING TEST. The date offered by the screening office may change, in which case the new date overwrites the existing date. The date of an appointment offered for a SCREENING TEST INVITATION by a screening office to a woman to undergo a SCREENING TEST. The date offered by the screening office may change, in which case a new SCREENING TEST INVITATION will be issued for the new date.

Reference:
Central Return KC62 Adult Screening Programmes - Breast Screening

This attribute is also known by these names:

Context	Alias
plural	TEST DATE OFFERED
plural	TEST DATES OFFERED

KC62 ANNEX

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

KC62 Annex: Adult Screening Programmes - Breast Screening

1. This is detailed information on each cancer detected for epidemiological comparisons to be made both within the SCREENING PROGRAMME and with data from other sources.

Line for each cancer detected (first column)

2. A separate line should be used for each PERSON with cancer detected.

Relevant tables (i.e. A, B, C1 etc.) (column 1)

3. The relevant table that the summary information has been included in for each PERSON with cancer detected.

KC62 Table A	First invitation for routine screening
KC62 Table B	Routine invitation to previous non-attenders
KC62 Table C1	Routine invitation to previous attenders (Last screen within 5 years)
KC62 Table C2	Routine invitation to previous attenders (Last screen more than 5 years)
KC62 Table D	Early Recalls
KC62 Table E	Self/GP referrals of women not screened previously
KC62 Table F1	Self/GP referrals of women screened previously (Last screen within 5 years)
KC62 Table F2	Self/GP referrals of women screened previously (Last screen more than 5 years previously)

Age at first offered appointment in this episode (years) (column 2)

4. This is derived from the BIRTH DATE of the PERSON and is their age at the time of their first TEST DATE OFFERED for women invited as part of a SCREENING PROGRAMME or FIRST TEST DATE OFFERED for women with a REFERRAL FOR SCREENING TEST.

Type of cancer (invasive, non-invasive or micro-invasive) (column 3)

5. The BIOPSY REFERRAL OUTCOME from the REQUEST FOR PATHOLOGY INVESTIGATION of the PERSON.
   
   Invasive is BIOPSY REFERRAL OUTCOME of Positive; i.e. cancer detected, invasive size not known or Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive status not known. Non-invasive is BIOPSY REFERRAL OUTCOME of Positive; i.e. cancer detected, non-invasive or possibly micro-invasive. Micro-invasive is BIOPSY REFERRAL OUTCOME of Positive; i.e. cancer detected, definitely micro-invasive.

Size of tumour (mm) (column 4)

6. The INVASIVE LESION SIZE from the REQUEST FOR PATHOLOGY INVESTIGATION of the PERSON.

Grade of tumour (I, II or III for invasive and high or low/intermediate for DCIS) (column 5)

7. The BIOPSY REFERRAL OUTCOME from the REQUEST FOR PATHOLOGY INVESTIGATION of the PERSON.
   
   Grade I is BIOPSY REFERRAL OUTCOME of Positive; i.e. cancer detected, invasive size not known, Grade I or Positive; i.e. cancer detected, invasive size known, Grade I. Grade II is BIOPSY REFERRAL OUTCOME of Positive; i.e. cancer detected, invasive size not known, Grade II or Positive; i.e. cancer detected, invasive size known, Grade II. Grade III is BIOPSY REFERRAL OUTCOME of Positive; i.e. cancer detected, invasive size not known, Grade III or Positive; i.e. cancer detected, invasive size known, Grade III. Low is BIOPSY REFERRAL OUTCOME of Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, low (DCIS only detected) or Positive; i.e. cancer detected, definitely micro-invasive, low (DCIS only detected). Intermediate is BIOPSY REFERRAL OUTCOME of Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, intermediate (DCIS only detected)or Positive; i.e. cancer detected, definitely micro-invasive, intermediate (DCIS only detected). High is BIOPSY REFERRAL OUTCOME of Positive; i.e. cancer detected non-invasive or possibly micro-invasive high (DCIS only detected) or Positive; i.e. cancer detected definitely micro-invasive high (DCIS only detected).

Number of lymph nodes sampled (column 6)

8. The number of REQUESTS FOR PATHOLOGY INVESTIGATION for the PERSON with a LYMPH NODE STATUS. Each lymph node sampled will be a different REQUEST FOR PATHOLOGY INVESTIGATION. Where their have been no lymph nodes sampled enter zero. If any LYMPH NODES STATUS are not yet available enter not known.

Number sampled positive (column 7)

9. The number of REQUESTS FOR PATHOLOGY INVESTIGATION for the PERSON with a LYMPH NODE STATUS of lymph node positive.

Number sampled negative (column 8)

10. The number of REQUESTS FOR PATHOLOGY INVESTIGATION for the PERSON with a LYMPH NODE STATUS of lymph node negative.

Histological type (column 9)

11. The CANCER HISTOLOGICAL TYPE from the REQUEST FOR PATHOLOGY INVESTIGATION of the PERSON.

KC62 TABLE A

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Part A4: Outcome measures

1. Part 4 presents a selection of outcome measures related to NHS Breast Screening Programme (NHSBSP) quality targets.
   

   Please note that where a column number is given within an outcome calculation, it relates to a specified column within the KC62 form for example:
   
   Number screened (technically adequate) (column 3) divided by Number of women invited (column 1) multiplied by 100 (for the appropriate age group).

   
   In this example (column 3) relates to Part 1 Invitations and Outcomes column 3.

Age Groups of women (first column)

2. Outcome measures are assessed within three groups: the first being those within the previous target age range of 50-64, the second within the current target age range of 50-70 and the third, the total of those reported, regardless of age.

Age Group (50-64) (line 37)

3. These are the outcome measures for women in the age group 50-64

Age Group (50-70) (line 38)

4. These are the outcome measures for women in the age group 50-70

Total all ages (line 39)

5. These are the outcome measures for women of all ages.

Uptake rate (% of invited) (column 36)

6. This column gives the uptake rate (also known as the acceptance rate) for screening. It is defined as the percentage of women who receive a technically adequate and complete screen as a result of an invitation for routine screening, and is calculated as:
   
   Number screened (technically adequate) (column 3) divided by Number of women invited (column 1) multiplied by 100 (for the appropriate age group).

Referral rate (% of screened) (column 37)

7. This column gives the rate of referrals to assessment from screening. It is defined as the percentage of women screened who are referred for any assessment procedure and is calculated as:
   
   Outcome of initial screen: Referred for assessment (column 7) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Non-invasive or micro-invasive cancers (per 1,000 screened) (column 38)

8. This column gives the cancers detected which are non-invasive, possibly micro-invasive, or definitely micro-invasive, per 1,000 screened calculated as:
   
   Non-invasive or possibly micro-invasive (column 27) plus Definitely microinvasive (column 28) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Benign biopsy rate (per 1,000 screened) (column 39)

9. This column gives the women screened who have an open biopsy with a result of benign or normal per 1,000 screened, calculated as:
   
   Up to and including open biopsy: Result: benign/normal (columns 22 + 23) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Benign Therapeutic operation: Number (column 40)

10. This column gives the number of women screened who had a REFERRAL FOR BREAST TREATMENT and who had a BENIGN THERAPEUTIC OPERATION by the appropriate age group.

Benign Therapeutic operation: Rate (per 1,000 screened) (column 41)

11. This column gives the women screened who have a BENIGN THERAPEUTIC OPERATION per 1,000 screened, calculated as:
    
    Number of BENIGN THERAPEUTIC OPERATIONS for the period (column 40) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Invasive cancer detection rate (per 1,000 screened) (column 42)

12. This column gives the rate of invasive cancers detected per 1,000 women screened, calculated as:
    
    Total invasive (column 35) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Detection rate of invasive cancers <10 mm (per 1,000 screened) (column 43)

13. This column gives the rate of invasive cancers smaller than 10mm detected per 1,000 women screened, calculated as:
    
    Invasive size < 10mm (column 29) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Detection rate of invasive cancers <15 mm (per 1,000 screened) (column 44)

14. This column gives the rate of invasive cancers smaller than 15mm detected per 1,000 women screened, calculated as:
    
    Invasive size < 15mm (columns 29 + 30) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Referral rate for cytology and/or core biopsy (% of screened) (column 45)

15. This column gives the percentage of women screened who are referred for fine needle aspiration cytology and/or core biopsy as part of the assessment process, calculated as:
    
    Referred for cytology and/or core biopsy (column 14) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Referral rate for open biopsy (% of screened) (column 46)

16. This column gives the percentage of women screened who are referred for an open biopsy, either directly from screening or following other assessment procedures, calculated as:
    
    Total open biopsy (column 20) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Pre-operative diagnosis rate (% of cancers diagnosed) (column 47)

17. This column gives the percentage of cancers diagnosed cytologically or histologically without surgery, calculated as:
    
    Not referred for open biopsy Cancer (column 18) divided by (Not referred for open biopsy Cancer (column 18) plus Open biopsy: Cancer (column 24)) multiplied by 100 (for the appropriate age group).

Early recall rate following assessment (% of screened) (column 48)

18. This column gives the percentage of women screened who are recommended for early recall following any assessment procedure, calculated as:
    
    Early recall (column 11) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Number of invasive cancers observed (column 49)

19. This column gives the total number of detected cancers classified as invasive, calculated as:
    
    Total invasive (column 35) (for the appropriate age group).

Number of invasive cancers expected (column 50)

20. This column is derived from the Number of invasive cancers observed (column 49) and a predefined incidence rate (calculated every three years for the appropriate age group).
    
    Please note KC62 is issued as an electronic spreadsheet and the predefined incident rate is contained within the spreadsheet for use within this calculation.

Standardised Detection Ratio (SDR) (column 51)

21. This column is derived from column 49 and column 50.
    
    Please note KC62 is issued as an electronic spreadsheet and the formula to calculate this ratio is contained within the spreadsheet.

Part A5: Data Completeness Indicators

22. Part A5 gives an indication of the completeness of data recorded on information systems in a variety of key areas.
    
    Please note that where a column number is given within an outcome calculation, it relates to a specified column within the KC62 form for example:
    
    Number screened (technically adequate) (column 3) divided by Number of women invited (column 1) multiplied by 100 (for the appropriate age group).
    
    In this example (column 3) relates to Part 1 Invitations and Outcomes column 3.

Age Groups of women (first column) in Part A5.

23. Data Completeness Indicators are assessed within three groups: the first being those within the previous target age range of 50-64, the second within the current target age range of 50-70 and the third, the total of those reported, regardless of age.

Age Group (50-64) (line 40)

24. These are the outcome measures for women in the previous target age group 50-64.

Age Group (50-70) (line 41)

25. These are the outcome measures for women in the current target age group 50-70.

Total all ages (line 42)

26. These are the outcome measures for all women reported, regardless of age.

Assessment result not known (% of referred) (column 52)

27. This column gives the percentage of women assessed for whom the final outcome of assessment is not recorded, calculated as:
    
    Outcome of assessment not known (column 9) divided by Referred for assessment (column 7) minus Failed to attend for assessment (column 8) multiplied by 100 (for the appropriate age group)

Cytology and/or core biopsy result not known (% of referred) (column 53)

28. This column gives the percentage of women referred for one or more cytology and/or core biopsy procedures, for whom a definitive result is not recorded and an open biopsy is not indicated. The column is calculated as:
    
    No result recorded/inadequate result (column 15) divided by Referred for cytology and/or core biopsy (column 14) multiplied by 100 (for the appropriate age group)

Open-biopsy result not known (% of referred) (column 54)

29. This column gives the percentage of women referred for an open biopsy for whom a definitive result is not recorded, calculated as:
    
    No result /inadequate result (column 21) divided by Total open biopsy (column 20) multiplied by 100 (for the appropriate age group)

Invasive status of cancer not known (% of all cancers diagnosed) (column 55)

30. This column gives the percentage of cancers diagnosed by cytology or histology in which the invasive status is not recorded. The column is calculated as:
    
    Invasive status not known (column 26) divided by Total number of women with cancer (column 25) multiplied by 100 (for the appropriate age group)

Size not known (% of invasive cancers) (column 56)

31. This column gives the percentage of cancers diagnosed by cytology or histology which are recorded as invasive, but have no size recorded. The column is calculated as:
    
    Size not known (column 34) divided by total number of women with invasive cancer Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Lymph node status not known (% of invasive cancers) (column 57)

32. This column gives the percentage of cancers diagnosed by cytology or histology which are recorded as invasive, but the lymph node status is unknown. The column is calculated as:
    
    The number of women where no LYMPH NODE STATUS has been recorded and where the BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known divided by total number of women with invasive cancer: Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Grade not known (% of invasive cancers) (column 58)

33. This column gives the percentage of cancers diagnosed by cytology or histology, which are recorded as invasive, but the cancer grade is not known. The column is calculated as:
    
    The number of women where the BIOPSY REFERRAL OUTCOME is Positive; i.e. cancer detected, invasive size not known, grade not known or Positive; i.e. cancer detected, invasive size known, grade not known divided by total number of women with invasive cancer: Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Special type not known (% of invasive cancers) (column 59)

34. This column gives the percentage of cancers diagnosed by cytology or histology which are recorded as invasive, but the special type is not known. The column is calculated as:
    
    The number of women where no INVASIVE CANCER SPECIAL TYPE INDICATOR has been recorded and where the BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known divided by Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Grade not known (% of DCIS) (column 60)

35. This column gives the percentage of cancers diagnosed by cytology or histology, which are recorded as ductal carcinoma in-situ (DCIS), but the grade is not known. The column is calculated as:
    
    The number of women where the BIOPSY REFERRAL OUTCOME is Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, grade not known (DCIS only detected) or Positive; i.e. cancer detected, definitely micro-invasive, grade not known (DCIS only detected) divided by total number of women with Non-invasive or possibly micro-invasive (column 27) plus Definitely micro-invasive (column 28) multiplied by 100 (for the appropriate age group)

Part A6: Status of cancer

36. Part A6 gives status and grades of cancers detected.

Age Groups of women (first column) in Part A6.

37. The status of cancers are assessed within three groups: the first being those within the previous target age range of 50-64, the second within the current target age range of 50-70 and the third, the total of those reported, regardless of age.

Age Group (50-64) (line 43)

38. This is the outcome measure for women in the previous target age group 50-64

Age Group (50-70) (line 44)

39. This is the outcome measure for women in the current target age group 50-70

Total all ages (line 45)

40. This is the outcome measure for all women reported, regardless of age.

Women with an invasive cancer detected: number with lymph nodes sampled (column 61)

41. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION where a LYMPH NODE STATUS has been recorded.

Women with an invasive cancer detected: number positive (column 62)

42. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known where at least one REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS of lymph node positive has been recorded.
    
    Note where more than one REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS has been recorded for a woman and any one of the LYMPH NODE STATUSES is lymph node positive, then the woman should be included in column 62, but should not be included in column 63.

Women with an invasive cancer detected: number negative (column 63)

43. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS of lymph node negative.
    
    Note where more than one REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS has been recorded for a woman, then every LYMPH NODE STATUS should be lymph node negative for inclusion in count for column 63. If any of the LYMPH NODE STATUSES is lymph node positive, then the woman should be included in column 62 and not included in column 63.

Women with an invasive cancer detected: number with 4 or more nodes assessed (column 64)

44. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected invasive size not known with four or more REQUEST FOR PATHOLOGY INVESTIGATION where a LYMPH NODE STATUS has been recorded.

Women with an invasive cancer detected: number with 4 or more nodes sampled: number positive (column 65)

45. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with four or more REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS, any one of which is lymph node positive.

Women with an invasive cancer detected: number with 4 or more nodes sampled: number negative (column 66)

46. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with four or more REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS, any one of which is lymph node negative.

Women with an invasive cancer detected: number grade 1 (column 67)

47. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known ,Grade I or Positive; i.e. cancer detected, invasive size not known, Grade I.

Women with an invasive cancer detected: number grade 2 (column 68)

48. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known ,Grade II or Positive; i.e. cancer detected, invasive size not known, Grade II.

Women with an invasive cancer detected: number grade 3 (column 69)

49. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known, Grade III or Positive; i.e. cancer detected, invasive size not known, Grade III.

Women with an invasive cancer detected: number special type (column 70)

50. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION with a INVASIVE CANCER SPECIAL TYPE INDICATOR of special type.

Women with an invasive cancer detected: number not special type (column 71)

51. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION with a INVASIVE CANCER SPECIAL TYPE INDICATOR of not special type.

Women with DCIS only detected: number low or intermediate grade (column 72)

52. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, non-invasive or possibly micro-invasive low (DCIS only detected) or Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, intermediate (DCIS only detected) or Positive; i.e. cancer detected, definitely micro- invasive, low (DCIS only detected) or Positive; i.e. cancer detected, definitely microinvasive, intermediate (DCIS only detected).

    Women with DCIS only detected: number high grade (column 73)

53. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, high (DCIS only detected) or Positive; i.e. cancer detected, definitely micro-invasive, high (DCIS only detected).

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Table A: 1st Invitation for Routine Screening

Part A3: Cancers Diagnosed

1. This part of the return describes the cancers formally diagnosed in women assessed as a result of screening. Only breast cancers should be reported, as defined in the Information and Training Manual for England and Wales.

Age at first offered appointment (first column)

2. This is derived from the BIRTH DATE of the PERSON and the TEST DATE OFFERED of the first SCREENING TEST INVITATION within the period of the return.

Total number of women with cancer (column 25)

3. Count of all women in columns 18 and 24 of Part 2 Assessment i.e. those women with a proven diagnosis of breast cancer.

Invasive status not known (column 26)

4. Count of women included in Part 3 with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected invasive status not known.

Non-invasive or possibly micro-invasive (column 27)

5. Count of women included in Part 3 with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected non-invasive or possibly micro-invasive.

Definitely micro-invasive (column 28)

6. Count of women included in Part 3 with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected definitely micro-invasive.

Invasive size (columns 29 - 33)

7. These columns count all cancers classified as invasive, separated according to the pathological size of the cancer (INVASIVE LESION SIZE). The BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected invasive size known.

Invasive size (of cancer)	<10mm (column 29)
Invasive size (of cancer)	>=10mm & <15mm (column 30)
Invasive size (of cancer)	>=15mm & <20mm (column 31)
Invasive size (of cancer)	>=20mm & <50mm (column 32)
Invasive size (of cancer)	>=50mm (column 33)

Invasive size: Size not known (column 34)

8. This column counts invasive cancers where the BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected invasive size not known.

Total invasive (column 35)

9. This column counts the total number of cancers classified as invasive, that is with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected invasive size known or Positive; i.e. cancer detected invasive size not known.

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Table A: 1st Invitation for Routine Screening

This table reports the PERSONS IN A SCREENING PROGRAMME for Breast Screening whose SCREENING STATUS is first call.


Part A1: Invitations and Outcomes

1. This is a summary of the outcomes of screening and assessment of all women invited and/or screened.

Age at first offered appointment (first column)

2. This is derived from the BIRTH DATE of the PERSON. Line 01 includes all women who were aged 44 or less at the time of the date of their first offered appointment for screening in the period covered by the return. Lines 02 to 09 include women in specified age groups. Line 10 includes all women who were aged 75 or over. Line 11 gives the total of all women in lines 03 to 08, giving a summary of the women in the NHS Breast Screening Programme target age range of 50 to 70 - the SCREENING POPULATION. Line 12 gives the total of all women in lines 01 to 10 regardless of age.

3. Lines 13 - 24 in Part A2 Assessment and lines 25 - 36 in Part A3 Cancer diagnosed follow the pattern described above.

Number of women invited (column 1)

4. Count of SCREENING TEST INVITATION where the first SCREENING TEST INVITATION has a FIRST TEST DATE OFFERED in the period covered by the return.

Lost to follow-up after technically inadequate screening mammogram (column 2)

5. Count of women whose SCREENING TEST RESULT classification was Inadequate test, and for whom no REFERRAL FOR BREAST ASSESSMENT was made.

Number screened (technically adequate) (column 3)

6. Count of women with a SCREENING TEST DATE in the period covered by the return whose SCREENING TEST RESULT classification was not Inadequate test.

Outcome of initial screen : Not known (column 4)

7. Count of women with a valid SCREENING TEST DATE but where no BREAST CANCER SCREENING TEST OUTCOME has been recorded.

Outcome of initial screen: Routine recall (column 5)

8. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Routine recall.

Outcome of initial screen: Early recall (column 6)

9. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Early recall but without a REFERRAL FOR BREAST ASSESSMENT.

Outcome of initial screen: Referred for assessment (column 7)

10. Count of women with a REFERRAL FOR BREAST ASSESSMENT. This covers all the women reported in columns 8 to 12.

Final outcome of assessment: Failed to attend for assessment (column 8)

11. Count of women with a REFERRAL FOR BREAST ASSESSMENT who failed to attend for all required assessment appointments and for whom there is no BREAST ASSESSMENT FINAL OUTCOME.

Final outcome of assessment: Outcome of assessment not known (column 9)

12. Count of women with a BREAST ASSESSMENT DATE but where no BREAST ASSESSMENT FINAL OUTCOME has been recorded.

Final outcome of assessment: Routine recall (column 10)

13. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Routine recall.

Final outcome of assessment: Early recall (column 11)

14. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Early recall.

Final outcome of assessment: Cancer (column 12)

15. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Cancer diagnosed. The total recorded in this column will equal the total recorded in columns 13, 18 and 24.

Part A2: Assessment

16. This part breaks down the outcomes of assessment by the procedures involved for all women assessed as a result of screening.

Cancer diagnosed without cytology or histology (column 13)

17. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification was Cancer diagnosed, but who had no REFERRAL FOR BIOPSY or a REFERRAL FOR BIOPSY where the PATHOLOGY INVESTIGATION TYPE classification was not Cytology and the BIOPSY REFERRAL OUTCOME classification was Inconclusive.

Referred for cytology and/or core biopsy (column 14)

18. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment and a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy.

Not referred for open biopsy: No result recorded/inadequate result (column 15)

19. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment and a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women did not complete any or all procedures within 6 months of the date of the screen or had no BREAST ASSESSMENT FINAL OUTCOME recorded.

Not referred for open biopsy: Routine recall (column 16)

20. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Routine recall.

Not referred for open biopsy: Early recall (column 17)

21. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Early recall.

Not referred for open biopsy: Cancer (column 18)

22. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Cancer diagnosed.

Referred for open biopsy (column 19)

23. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy followed by a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy).

Total referred for open biopsy (column 20)

24. Total count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy).

Up to and including open biopsy: No result/inadequate result (column 21)

25. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BIOPSY REFERRAL OUTCOME classification of Inconclusive or Biopsy not done or result not yet known or did not attend for the biopsy within 6 months of the date of the SCREENING TEST having no recorded DATE BIOPSY TAKEN.

Up to and including open biopsy: Result: Benign/normal: Routine recall (column 22)

26. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). The BIOPSY REFERRAL OUTCOME classification is Benign or negative. The BREAST ASSESSMENT FINAL OUTCOME classification for these women is Routine recall.

Up to and including open biopsy: Result: Benign/normal: Early recall (column 23)

27. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). The BIOPSY REFERRAL OUTCOME classification is Benign or negative. The BREAST ASSESSMENT FINAL OUTCOME classification for these women is Early recall.

Up to and including open biopsy: Cancer (column 24)

28. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). The BIOPSY REFERRAL OUTCOME classification is Positive; i.e cancer diagnosed. The BREAST ASSESSMENT FINAL OUTCOME classification for these women is Cancer diagnosed.

KC62 TABLE B

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Table B: Routine invitation to previous non-attenders

This table reports the PERSON IN A SCREENING PROGRAMME for Breast Screening whose SCREENING STATUS is routine call and the last SCREENING TEST INVITATION resulted in ATTENDED OR DID NOT ATTEND of Patient arrived late and could not be seen or Appointment cancelled by the patient or Did not attend - no advance warning given.


Part B1: Invitations and Outcomes

1. This is a summary of the outcomes of screening and assessment of all women invited and/or screened.

Age at first offered appointment (first column)

2. This is derived from the BIRTH DATE of the PERSON. Line 01 includes all women who were aged 44 or less at the time of the date of their first offered appointment for screening in the period covered by the return. Lines 02 to 09 include women in specified age groups. Line 10 includes all women who were aged 75 or over. Line 11 gives the total of all women in lines 03 to 08, giving a summary of the women in the NHS Breast Screening Programme target age range of 50 to 70 - the SCREENING POPULATION. Line 12 gives the total of all women in lines 01 to 10 regardless of age.

3. Lines 13 - 24 in Part B2 Assessment and lines 25 - 36 in Part B3 Cancers diagnosed follow the pattern described above.

Number of women invited (column 1)

4. Count of SCREENING TEST INVITATIONS where the first SCREENING TEST INVITATION has a TEST DATE OFFERED in the period covered by the return.

Lost to follow-up after technically inadequate screening mammogram (column 2)

5. Count of women whose SCREENING TEST RESULT classification was Inadequate test, and for whom no REFERRAL FOR BREAST ASSESSMENT was made.

Number screened (technically adequate) (column 3)

6. Count of women with a SCREENING TEST DATE in the period covered by the return whose SCREENING TEST RESULT classification was not Inadequate test.

Outcome of initial screen : Not known (column 4)

7. Count of women with a valid SCREENING TEST DATE but where no BREAST CANCER SCREENING TEST OUTCOME has been recorded.

Outcome of initial screen: Routine recall (column 5)

8. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Routine recall.

Outcome of initial screen: Early recall (column 6)

9. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Early recall but without a REFERRAL FOR BREAST ASSESSMENT.

Outcome of initial screen: Referred for assessment (column 7)

10. Count of women with a REFERRAL FOR BREAST ASSESSMENT. This covers all the women reported in columns 8 to 12.

Final outcome of assessment: Failed to attend for assessment (column 8)

11. Count of women with a REFERRAL FOR BREAST ASSESSMENT who failed to attend for all required assessment appointments and for whom there is no BREAST ASSESSMENT FINAL OUTCOME.

Final outcome of assessment: Outcome of assessment not known (column 9)

12. Count of women with a BREAST ASSESSMENT DATE but where no BREAST ASSESSMENT FINAL OUTCOME has been recorded.

Final outcome of assessment: Routine recall (column 10)

13. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Routine recall.

Final outcome of assessment: Early recall (column 11)

14. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Early recall.

Final outcome of assessment: Cancer (column 12)

15. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Cancer diagnosed. The total recorded in this column will equal the total recorded in columns 13, 18 and 24.

Part B2: Assessment

16. This part breaks down the outcomes of assessment by the procedures involved for all women assessed as a result of screening.

Cancer diagnosed without cytology or histology (column 13)

17. Count of women with a BREAST ASSESSMENT DATE whose BREAST ASSESSMENT FINAL OUTCOME classification was Cancer diagnosed, but who had no REFERRAL FOR BIOPSY or a REFERRAL FOR BIOPSY where the PATHOLOGY INVESTIGATION TYPE classification was not Cytology and the BIOPSY REFERRAL OUTCOME classification was Inconclusive.

Referred for cytology and/or core biopsy (column 14)

18. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment and a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy.

Not referred for open biopsy: No result recorded/inadequate result (column 15)

19. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment and a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women did not complete any or all procedures within 6 months of the date of the screen or had no BREAST ASSESSMENT FINAL OUTCOME recorded.

Not referred for open biopsy: Routine recall (column 16)

20. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Routine recall.

Not referred for open biopsy: Early recall (column 17)

21. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Early recall.

Not referred for open biopsy: Cancer (column 18)

22. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Cancer diagnosed.

Referred for open biopsy (column 19)

23. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy followed by a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy).

Total referred for open biopsy (column 20)

24. Total count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy).

Up to and including open biopsy: No result/inadequate result (column 21)

25. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BIOPSY REFERRAL OUTCOME classification of Inconclusive or Biopsy not done or result not yet known or did not attend for the biopsy within 6 months of the date of the SCREENING TEST having no recorded DATE BIOPSY TAKEN.

Up to and including open biopsy: Result: Benign/normal: Routine recall (column 22)

26. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). The BIOPSY REFERRAL OUTCOME classification is Benign or negative. The BREAST ASSESSMENT FINAL OUTCOME classification for these women is Routine recall.

Up to and including open biopsy: Result: Benign/normal: Early recall (column 23)

27. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). The BIOPSY REFERRAL OUTCOME classification is Benign or negative. The BREAST ASSESSMENT FINAL OUTCOME classification for these women is Early recall.

Up to and including open biopsy: Cancer (column 24)

28. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). The BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer diagnosed. The BREAST ASSESSMENT FINAL OUTCOME classification for these women is Cancer diagnosed.

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Table B: Routine invitation to previous non-attenders

Part B3: Cancers Diagnosed

1. This part of the return describes the cancers formally diagnosed in women assessed as a result of screening. Only breast cancers should be reported, as defined in the Information and Training Manual for England and Wales.

Age at first offered appointment (first column)

2. This is derived from the BIRTH DATE of the PERSON and the TEST DATE OFFERED of the first SCREENING TEST INVITATION within the period of the return.

Total number of women with cancer (column 25)

3. Count of all women in columns 18 and 24 of Part 2 Assessment i.e. those women with a proven diagnosis of breast cancer.

Invasive status not known (column 26)

4. Count of women included in Part 3 with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected invasive status not known.

Non-invasive or possibly micro-invasive (column 27)

5. Count of women included in Part 3 with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected non-invasive or possibly micro-invasive.

Definitely micro-invasive (column 28)

6. Count of women included in Part 3 with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected definitely micro-invasive.

Invasive size (columns 29 - 33)

7. These columns count all cancers classified as invasive, separated according to the pathological size of the cancer (INVASIVE LESION SIZE). The BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected invasive size known.

Invasive size (of cancer)	<10mm (column 29)
Invasive size (of cancer)	>=10mm & <15mm (column 30)
Invasive size (of cancer)	>=15mm & <20mm (column 31)
Invasive size (of cancer)	>=20mm & <50mm (column 32)
Invasive size (of cancer)	>=50mm (column 33)

Invasive size: Size not known (column 34)

8. This column counts invasive cancers where the BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected invasive size not known.

Total invasive (column 35)

9. This column counts the total number of cancers classified as invasive, that is with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected invasive size known or Positive; i.e. cancer detected invasive size not known.

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Table B: Routine invitation to previous non-attenders

Part B4: Outcome measures

1. Part 4 presents a selection of outcome measures related to NHS Breast Screening Programme (NHSBSP) quality targets.
   

   Please note that where a column number is given within an outcome calculation, it relates to a specified column within the KC62 form for example:
   
   Number screened (technically adequate) (column 3) divided by Number of women invited (column 1) multiplied by 100 (for the appropriate age group).

   
   In this example (column 3) relates to Part 1 Invitations and Outcomes column 3.

Age Groups of women (first column)

2. Outcome measures are assessed within three groups: the first being those within the previous target age range of 50-64, the second within the current target age range of 50-70 and the third, the total of those reported, regardless of age.

Age Group(50-64) (line 37)

3. These are the outcome measures for women in the age group 50-64

Age Group (50-70) (line 38)

4. These are the outcome measures for women in the age group 50-70

Total all ages (line 39)

5. These are the outcome measures for women of all ages.

Uptake rate (% of invited) (column 36)

6. This column gives the uptake rate (also known as the acceptance rate) for screening. It is defined as the percentage of women who receive a technically adequate and complete screen as a result of an invitation for routine screening, and is calculated as:
   
   Number screened (technically adequate) (column 3) divided by Number of women invited (column 1) multiplied by 100 (for the appropriate age group).

Referral rate (% of screened) (column 37)

7. This column gives the rate of referrals to assessment from screening. It is defined as the percentage of women screened who are referred for any assessment procedure and is calculated as:
   
   Outcome of initial screen: Referred for assessment (column 7) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Non-invasive or micro-invasive cancers (per 1,000 screened) (column 38)

8. This column gives the cancers detected which are non-invasive, possibly micro-invasive, or definitely micro-invasive, per 1,000 screened calculated as:
   
   Non-invasive or possibly micro-invasive (column 27) plus Definitely micro-invasive (column 28) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Benign biopsy rate (per 1,000 screened) (column 39)

9. This column gives the women screened who have an open biopsy with a result of benign or normal per 1,000 screened, calculated as:
   
   Up to and including open biopsy: Result: benign/normal (columns 22 + 23) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Benign Therapeutic operation: Number (column 40)

10. This column gives the number of women screened who had a REFERRAL FOR BREAST TREATMENT and who had a BENIGN THERAPEUTIC OPERATION by the appropriate age group.

Benign Therapeutic operation: Rate (per 1,000 screened) (column 41)

11. This column gives the women screened who have a BENIGN THERAPEUTIC OPERATION per 1,000 screened, calculated as:
    
    Number of BENIGN THERAPEUTIC OPERATIONS for the period (column 40) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Invasive cancer detection rate (per 1,000 screened) (column 42)

12. This column gives the rate of invasive cancers detected per 1,000 women screened, calculated as:
    
    Total invasive (column 35) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Detection rate of invasive cancers <10 mm (per 1,000 screened) (column 43)

13. This column gives the rate of invasive cancers smaller than 10mm detected per 1,000 women screened, calculated as:
    
    Invasive size < 10mm (column 29) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Detection rate of invasive cancers <15 mm (per 1,000 screened) (column 44)

14. This column gives the rate of invasive cancers smaller than 15mm detected per 1,000 women screened, calculated as:
    
    Invasive size < 15mm (columns 29 + 30) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Referral rate for cytology and/or core biopsy (% of screened) (column 45)

15. This column gives the percentage of women screened who are referred for fine needle aspiration cytology and/or core biopsy as part of the assessment process, calculated as:
    
    Referred for cytology and/or core biopsy (column 14) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Referral rate for open biopsy (% of screened) (column 46)

16. This column gives the percentage of women screened who are referred for an open biopsy, either directly from screening or following other assessment procedures, calculated as:
    
    Total open biopsy (column 20) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Pre-operative diagnosis rate (% of cancers diagnosed) (column 47)

17. This column gives the percentage of cancers diagnosed cytologically or histologically without surgery, calculated as:
    
    Not referred for open biopsy Cancer (column 18) divided by (Not referred for open biopsy Cancer (column 18) plus Open biopsy: Cancer (column 24)) multiplied by 100 (for the appropriate age group).

Early recall rate following assessment (% of screened) (column 48)

18. This column gives the percentage of women screened who are recommended for early recall following any assessment procedure, calculated as:
    
    Early recall (column 11) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Number of invasive cancers observed (column 49)

19. This column gives the total number of detected cancers classified as invasive, calculated as:
    
    Total invasive (column 35) (for the appropriate age group).

Number of invasive cancers expected (column 50)

20. This column is derived from the Number of invasive cancers observed (column 49) and a predefined incidence rate (calculated every three years for the appropriate age group).
    
    Please note KC62 is issued as an electronic spreadsheet and the predefined incident rate is contained within the spreadsheet for use within this calculation.

Standardised Detection Ratio (SDR) (column 51)

21. This column is derived from column 49 and column 50.
    
    Please note KC62 is issued as an electronic spreadsheet and the formula to calculate this ratio is contained within the spreadsheet.

Part B5: Data Completeness Indicators

22. Part B5 gives an indication of the completeness of data recorded on information systems in a variety of key areas.
    
    Please note that where a column number is given within an outcome calculation, it relates to a specified column within the KC62 form for example:
    
    Number screened (technically adequate) (column 3) divided by Number of women invited (column 1) multiplied by 100 (for the appropriate age group).
    
    In this example (column 3) relates to Part 1 Invitations and Outcomes column 3.

Age Groups of women (first column) in Part B5.

23. Data Completeness Indicators are assessed within three groups: the first being those within the previous target age range of 50-64, the second within the current target age range of 50-70 and the third, the total of those reported, regardless of age.

Age Group (50-64) (line 40)

24. These are the outcome measures for women in the previous target age group 50-64.

Age Group (50-70) (line 41)

25. These are the outcome measures for women in the current target age group 50-70.

Total all ages (line 42)

26. These are the outcome measures for all women reported, regardless of age.

Assessment result not known (% of referred) (column 52)

27. This column gives the percentage of women assessed for whom the final outcome of assessment is not recorded, calculated as:
    
    Outcome of assessment not known (column 9) divided by Referred for assessment (column 7) minus Failed to attend for assessment (column 8) multiplied by 100 (for the appropriate age group)

Cytology and/or core biopsy result not known (% of referred) (column 53)

28. This column gives the percentage of women referred for one or more cytology and/or core biopsy procedures, for whom a definitive result is not recorded and an open biopsy is not indicated. The column is calculated as:
    
    No result recorded/inadequate result (column 15) divided by Referred for cytology and/or core biopsy (column 14) multiplied by 100 (for the appropriate age group)

Open-biopsy result not known (% of referred) (column 54)

29. This column gives the percentage of women referred for an open biopsy for whom a definitive result is not recorded, calculated as:
    
    No result /inadequate result (column 21) divided by Total open biopsy (column 20) multiplied by 100 (for the appropriate age group)

Invasive status of cancer not known (% of all cancers diagnosed) (column 55)

30. This column gives the percentage of cancers diagnosed by cytology or histology in which the invasive status is not recorded. The column is calculated as:
    
    Invasive status not known (column 26) divided by Total number of women with cancer (column 25) multiplied by 100 (for the appropriate age group)

Size not known (% of invasive cancers) (column 56)

31. This column gives the percentage of cancers diagnosed by cytology or histology which are recorded as invasive, but have no size recorded. The column is calculated as:
    
    Size not known (column 34) divided by total number of women with invasive cancer Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Lymph node status not known (% of invasive cancers) (column 57)

32. This column gives the percentage of cancers diagnosed by cytology or histology which are recorded as invasive, but the lymph node status is unknown. The column is calculated as:
    
    The number of women where no LYMPH NODE STATUS has been recorded and where the BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known divided by total number of women with invasive cancer: Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Grade not known (% of invasive cancers) (column 58)

33. This column gives the percentage of cancers diagnosed by cytology or histology, which are recorded as invasive, but the cancer grade is not known. The column is calculated as:
    
    The number of women where the BIOPSY REFERRAL OUTCOME is Positive; i.e. cancer detected, invasive size not known, grade not known or Positive; i.e. cancer detected, invasive size known, grade not known divided by total number of women with invasive cancer: Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Special type not known (% of invasive cancers) (column 59)

34. This column gives the percentage of cancers diagnosed by cytology or histology which are recorded as invasive, but the special type is not known. The column is calculated as:
    
    The number of women where no INVASIVE CANCER SPECIAL TYPE INDICATOR has been recorded and where the BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known divided by Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Grade not known (% of DCIS) (column 60)

35. This column gives the percentage of cancers diagnosed by cytology or histology, which are recorded as ductal carcinoma in-situ (DCIS), but the grade is not known. The column is calculated as:
    
    The number of women where the BIOPSY REFERRAL OUTCOME is Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, grade not known (DCIS only detected) or Positive; i.e. cancer detected, definitely micro-invasive, grade not known (DCIS only detected) divided by total number of women with Non-invasive or possibly micro-invasive (column 27) plus Definitely micro-invasive (column 28) multiplied by 100 (for the appropriate age group)

Part B6: Status of cancer

36. Part B6 gives status and grades of cancers detected.

Age Groups of women (first column) in Part B6.

37. The status of cancers are assessed within three groups: the first being those within the previous target age range of 50-64, the second within the current target age range of 50-70 and the third, the total of those reported, regardless of age.

Age Group(50-64) (line 43)

38. This is the outcome measure for women in the previous target age group 50-64

Age Group (50-70) (line 44)

39. This is the outcome measure for women in the current target age group 50-70

Total all ages (line 45)

40. This is the outcome measure for all women reported, regardless of age.

Women with an invasive cancer detected: number with lymph nodes sampled (column 61)

41. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION where a LYMPH NODE STATUS has been recorded.

Women with an invasive cancer detected: number positive (column 62)

42. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known where at least one REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS of lymph node positive has been recorded.
    
    Note where more than one REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS has been recorded for a woman and any one of the LYMPH NODE STATUSES is lymph node positive, then the woman should be included in column 62, but should not be included in column 63.

Women with an invasive cancer detected: number negative (column 63)

43. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS of lymph node negative.
    
    Note where more than one REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS has been recorded for a woman, then every LYMPH NODE STATUS should be lymph node negative for inclusion in count for column 63. If any of the LYMPH NODE STATUSES is lymph node positive, then the woman should be included in column 62 and not included in column 63.

Women with an invasive cancer detected: number with 4 or more nodes assessed (column 64)

44. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected invasive size not known with four or more REQUEST FOR PATHOLOGY INVESTIGATION where a LYMPH NODE STATUS has been recorded.

Women with an invasive cancer detected: number with 4 or more nodes sampled: number positive (column 65)

45. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with four or more REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS, any one of which is lymph node positive.

Women with an invasive cancer detected: number with 4 or more nodes sampled: number negative (column 66)

46. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with four or more REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS, any one of which is lymph node negative.

Women with an invasive cancer detected: number grade 1 (column 67)

47. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known ,Grade I or Positive; i.e. cancer detected, invasive size not known, Grade I.

Women with an invasive cancer detected: number grade 2 (column 68)

48. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known ,Grade II or Positive; i.e. cancer detected, invasive size not known, Grade II.

Women with an invasive cancer detected: number grade 3 (column 69)

49. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known, Grade III or Positive; i.e. cancer detected, invasive size not known, Grade III.

Women with an invasive cancer detected: number special type (column 70)

50. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION with a INVASIVE CANCER SPECIAL TYPE INDICATOR of special type.

Women with an invasive cancer detected: number not special type (column 71)

51. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION with a INVASIVE CANCER SPECIAL TYPE INDICATOR of not special type.

Women with DCIS only detected: number low or intermediate grade (column 72)

52. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, non-invasive or possibly micro-invasive low (DCIS only detected) or Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, intermediate (DCIS only detected) or Positive; i.e. cancer detected, definitely micro- invasive, low (DCIS only detected) or Positive; i.e. cancer detected, definitely microinvasive, intermediate (DCIS only detected).

    Women with DCIS only detected: number high grade (column 73)

53. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, high (DCIS only detected) or Positive; i.e. cancer detected, definitely micro-invasive, high (DCIS only detected).

KC62 TABLE C1

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Table C1: Routine invitation to previous attenders (Last screen within 5 years)

This table reports the PERSON IN A SCREENING PROGRAMME for Breast Screening whose SCREENING STATUS is routine recall and the last SCREENING TEST was within 5 years.


Part C1/1: Invitations and Outcomes

1. This is a summary of the outcomes of screening and assessment of all women invited and/or screened.

Age at first offered appointment (first column)

2. This is derived from the BIRTH DATE. Line 1 includes all women who were aged 44 or less at the time of the date of their first offered appointment for screening in the period covered by the return. Lines 02 to 09 include women in specified age groups. Line 10 includes all women who were aged 75 or over. Line 11 gives the total of all women in lines 03 to 08, giving a summary of the women in the NHS Breast Screening Programme target age range of 50 to 70 - the SCREENING POPULATION. Line 12 gives the total of all women in lines 01 and 10 regardless of age.

3. Lines 13 - 24 in Part C1/2 Assessment and lines 25 - 36 in Part C1/2 Cancers diagnosed follow the pattern described above.

Number of women invited (column 1)

4. Count of SCREENING TEST INVITATIONS where the first SCREENING TEST INVITATIONhas a TEST DATE OFFERED in the period covered by the return.

Lost to follow-up after technically inadequate screening mammogram (column 2)

5. Count of women whose SCREENING TEST RESULT classification was Inadequate test, and for whom no REFERRAL FOR BREAST ASSESSMENT was made.

Number screened (technically adequate) (column 3)

6. Count of women with a SCREENING TEST DATE in the period covered by the return whose SCREENING TEST RESULT classification was not Inadequate test.

Outcome of initial screen : Not known (column 4)

7. Count of women with a valid SCREENING TEST DATE but where no BREAST CANCER SCREENING TEST OUTCOME has been recorded.

Outcome of initial screen: Routine recall (column 5)

8. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Routine recall.

Outcome of initial screen: Early recall (column 6)

9. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Early recall but without a REFERRAL FOR BREAST ASSESSMENT.

Outcome of initial screen: Referred for assessment (column 7)

10. Count of women with a REFERRAL FOR BREAST ASSESSMENT. This covers all the women reported in columns 8 to 12.

Final outcome of assessment: Failed to attend for assessment (column 8)

11. Count of women with a REFERRAL FOR BREAST ASSESSMENT who failed to attend for all required assessment appointments and for whom there is no BREAST ASSESSMENT FINAL OUTCOME.

Final outcome of assessment: Outcome of assessment not known (column 9)

12. Count of women with a BREAST ASSESSMENT DATE but where no BREAST ASSESSMENT FINAL OUTCOME has been recorded

Final outcome of assessment: Routine recall (column 10)

13. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Routine recall.

Final outcome of assessment: Early recall (column 11)

14. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Early recall.

Final outcome of assessment: Cancer (column 12)

15. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Cancer diagnosed. The total recorded in this column will equal the total recorded in columns 13, 18 and 24.

Part C1/2: Assessment

16. This part breaks down the outcomes of assessment by the procedures involved for all women assessed as a result of screening.

Cancer diagnosed without cytology or histology (column 13)

17. Count of women with a BREAST ASSESSMENT DATE whose BREAST ASSESSMENT FINAL OUTCOME classification was Cancer diagnosed, but who had no REFERRAL FOR BIOPSY or aREFERRAL FOR BIOPSY where the PATHOLOGY INVESTIGATION TYPE classification was not Cytology and the BIOPSY REFERRAL OUTCOME classification was Inconclusive.

Referred for cytology and/or core biopsy (column 14)

18. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment and a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy.

Not referred for open biopsy: No result recorded/inadequate result (column 15)

19. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment and a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women did not complete any or all procedures within 6 months of the date of the screen or had no BREAST ASSESSMENT FINAL OUTCOME recorded.

Not referred for open biopsy: Routine recall (column 16)

20. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Routine recall.

Not referred for open biopsy: Early recall (column 17)

21. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Early recall.

Not referred for open biopsy: Cancer (column 18)

22. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Cancer diagnosed.

Referred for open biopsy (column 19)

23. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy followed by a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy).

Total referred for open biopsy (column 20)

24. Total count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy).

Up to and including open biopsy: No result/inadequate result (column 21)

25. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BIOPSY REFERRAL OUTCOME classification of Inconclusive or Biopsy not done or result not yet known or did not attend for the biopsy within 6 months of the date of the SCREENING TEST having no recorded DATE BIOPSY TAKEN.

Up to and including open biopsy: Result: Benign/normal: Routine recall (column 22)

26. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). The BIOPSY REFERRAL OUTCOME classification is Benign or negative. The BREAST ASSESSMENT FINAL OUTCOME classification for these women is Routine recall.

Up to and including open biopsy: Result: Benign/normal: Early recall (column 23)

27. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). The BIOPSY REFERRAL OUTCOME classification is Benign or negative. The BREAST ASSESSMENT FINAL OUTCOME classification for these women is Early recall.

Up to and including open biopsy: Cancer (column 24)

28. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). The BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer diagnosed. The BREAST ASSESSMENT FINAL OUTCOME classification for these women is Cancer diagnosed.

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Table C1: Routine invitation to previous attenders (Last screen within 5 years)

Part C1/3: Cancers Diagnosed

1. This part of the return describes the cancers formally diagnosed in women assessed as a result of screening. Only breast cancers should be reported, as defined in the Information and Training Manual for England and Wales.

Age at first offered appointment (first column)

2. This is derived from the BIRTH DATE of the PERSON and the TEST DATE OFFERED of the first SCREENING TEST INVITATION within the period of the return.

Total number of women with cancer (column 25)

3. Count of all women in columns 18 and 24 of Part 2 Assessment i.e. those women with a proven diagnosis of breast cancer.

Invasive status not known (column 26)

4. Count of women included in Part 3 with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected invasive status not known.

Non-invasive or possibly micro-invasive (column 27)

5. Count of women included in Part 3 with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected non-invasive or possibly micro-invasive.

Definitely micro-invasive (column 28)

6. Count of women included in Part 3 with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected definitely micro-invasive.

Invasive size (columns 29 - 33)

7. These columns count all cancers classified as invasive, separated according to the pathological size of the cancer (INVASIVE LESION SIZE). The BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected Invasive size known.

Invasive size (of cancer)	<10mm (column 29)
Invasive size (of cancer)	>=10mm & <15mm (column 30)
Invasive size (of cancer)	>=15mm & <20mm (column 31)
Invasive size (of cancer)	>=20mm & <50mm (column 32)
Invasive size (of cancer)	>=50mm (column 33)

Invasive size: Size not known (column 34)

8. This column counts invasive cancers where the BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected invasive size not known.

Total invasive (column 35)

9. This column counts the total number of cancers classified as invasive, that is with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected invasive size known or Positive; i.e. cancer detected invasive size not known

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Table C1: Routine invitation to previous attenders (Last screen within 5 years)

Part C1/4: Outcome measures

1. Part 4 presents a selection of outcome measures related to NHS Breast Screening Programme (NHSBSP) quality targets.
   

   Please note that where a column number is given within an outcome calculation, it relates to a specified column within the KC62 form for example:
   
   Number screened (technically adequate) (column 3) divided by Number of women invited (column 1) multiplied by 100 (for the appropriate age group).

   
   In this example (column 3) relates to Part 1 Invitations and Outcomes column 3.

Age Groups of women (first column)

2. Outcome measures are assessed within three groups: the first being those within the previous target age range of 50-64, the second within the current target age range of 50-70 and the third, the total of those reported, regardless of age.

Age Group (50-64) (line 37)

3. These are the outcome measures for women in the age group 50-64

Age Group (50-70) (line 38)

4. These are the outcome measures for women in the age group 50-70

Total all ages (line 39)

5. These are the outcome measures for women of all ages.

Uptake rate (% of invited) (column 36)

6. This column gives the uptake rate (also known as the acceptance rate) for screening. It is defined as the percentage of women who receive a technically adequate and complete screen as a result of an invitation for routine screening, and is calculated as:
   
   Number screened (technically adequate) (column 3) divided by Number of women invited (column 1) multiplied by 100 (for the appropriate age group).

Referral rate (% of screened) (column 37)

7. This column gives the rate of referrals to assessment from screening. It is defined as the percentage of women screened who are referred for any assessment procedure and is calculated as:
   
   Outcome of initial screen: Referred for assessment (column 7) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Non-invasive or micro-invasive cancers (per 1,000 screened) (column 38)

8. This column gives the cancers detected which are non-invasive, possibly micro-invasive, or definitely micro-invasive, per 1,000 screened calculated as:
   
   Non-invasive or possibly micro-invasive (column 27) plus Definitely micro-invasive (column 28) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Benign biopsy rate (per 1,000 screened) (column 39)

9. This column gives the women screened who have an open biopsy with a result of benign or normal per 1,000 screened, calculated as:
   
   Up to and including open biopsy: Result: benign/normal (columns 22 + 23) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Benign Therapeutic operation: Number (column 40)

10. This column gives the number of women screened who had a REFERRAL FOR BREAST TREATMENT and who had a BENIGN THERAPEUTIC OPERATION by the appropriate age group.

Benign Therapeutic operation: Rate (per 1,000 screened) (column 41)

11. This column gives the women screened who have a BENIGN THERAPEUTIC OPERATION per 1,000 screened, calculated as:
    
    Number of BENIGN THERAPEUTIC OPERATIONS for the period (column 40) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Invasive cancer detection rate (per 1,000 screened) (column 42)

12. This column gives the rate of invasive cancers detected per 1,000 women screened, calculated as:
    
    Total invasive (column 35) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Detection rate of invasive cancers <10 mm (per 1,000 screened) (column 43)

13. This column gives the rate of invasive cancers smaller than 10mm detected per 1,000 women screened, calculated as:
    
    Invasive size < 10mm (column 29) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Detection rate of invasive cancers <15 mm (per 1,000 screened) (column 44)

14. This column gives the rate of invasive cancers smaller than 15mm detected per 1,000 women screened, calculated as:
    
    Invasive size < 15mm (columns 29 + 30) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Referral rate for cytology and/or core biopsy (% of screened) (column 45)

15. This column gives the percentage of women screened who are referred for fine needle aspiration cytology and/or core biopsy as part of the assessment process, calculated as:
    
    Referred for cytology and/or core biopsy (column 14) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Referral rate for open biopsy (% of screened) (column 46)

16. This column gives the percentage of women screened who are referred for an open biopsy, either directly from screening or following other assessment procedures, calculated as:
    
    Total open biopsy (column 20) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Pre-operative diagnosis rate (% of cancers diagnosed) (column 47)

17. This column gives the percentage of cancers diagnosed cytologically or histologically without surgery, calculated as:
    
    Not referred for open biopsy Cancer (column 18) divided by (Not referred for open biopsy Cancer (column 18) plus Open biopsy: Cancer (column 24)) multiplied by 100 (for the appropriate age group).

Early recall rate following assessment (% of screened) (column 48)

18. This column gives the percentage of women screened who are recommended for early recall following any assessment procedure, calculated as:
    
    Early recall (column 11) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Number of invasive cancers observed (column 49)

19. This column gives the total number of detected cancers classified as invasive, calculated as:
    
    Total invasive (column 35) (for the appropriate age group).

Number of invasive cancers expected (column 50)

20. This column is derived from the Number of invasive cancers observed (column 49) and a predefined incidence rate (calculated every three years for the appropriate age group).
    
    Please note KC62 is issued as an electronic spreadsheet and the predefined incident rate is contained within the spreadsheet for use within this calculation.

Standardised Detection Ratio (SDR) (column 51)

21. This column is derived from column 49 and column 50.
    
    Please note KC62 is issued as an electronic spreadsheet and the formula to calculate this ratio is contained within the spreadsheet.

Part C1/5: Data Completeness Indicators

22. Part C1/5 gives an indication of the completeness of data recorded on information systems in a variety of key areas.
    
    Please note that where a column number is given within an outcome calculation, it relates to a specified column within the KC62 form for example:
    
    Number screened (technically adequate) (column 3) divided by Number of women invited (column 1) multiplied by 100 (for the appropriate age group).
    
    In this example (column 3) relates to Part 1 Invitations and Outcomes column 3.

Age Groups of women (first column) in Part C1/5.

23. Data Completeness Indicators are assessed within three groups: the first being those within the previous target age range of 50-64, the second within the current target age range of 50-70 and the third, the total of those reported, regardless of age.

Age Group (50-64) (line 40)

24. These are the outcome measures for women in the previous target age group 50-64.

Age Group (50-70) (line 41)

25. These are the outcome measures for women in the current target age group 50-70.

Total all ages (line 42)

26. These are the outcome measures for all women reported, regardless of age.

Assessment result not known (% of referred) (column 52)

27. This column gives the percentage of women assessed for whom the final outcome of assessment is not recorded, calculated as:
    
    Outcome of assessment not known (column 9) divided by Referred for assessment (column 7) minus Failed to attend for assessment (column 8) multiplied by 100 (for the appropriate age group)

Cytology and/or core biopsy result not known (% of referred) (column 53)

28. This column gives the percentage of women referred for one or more cytology and/or core biopsy procedures, for whom a definitive result is not recorded and an open biopsy is not indicated. The column is calculated as:
    
    No result recorded/inadequate result (column 15) divided by Referred for cytology and/or core biopsy (column 14) multiplied by 100 (for the appropriate age group)

Open-biopsy result not known (% of referred) (column 54)

29. This column gives the percentage of women referred for an open biopsy for whom a definitive result is not recorded, calculated as:
    
    No result /inadequate result (column 21) divided by Total open biopsy (column 20) multiplied by 100 (for the appropriate age group)

Invasive status of cancer not known (% of all cancers diagnosed) (column 55)

30. This column gives the percentage of cancers diagnosed by cytology or histology in which the invasive status is not recorded. The column is calculated as:
    
    Invasive status not known (column 26) divided by Total number of women with cancer (column 25) multiplied by 100 (for the appropriate age group)

Size not known (% of invasive cancers) (column 56)

31. This column gives the percentage of cancers diagnosed by cytology or histology which are recorded as invasive, but have no size recorded. The column is calculated as:
    
    Size not known (column 34) divided by total number of women with invasive cancer Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Lymph node status not known (% of invasive cancers) (column 57)

32. This column gives the percentage of cancers diagnosed by cytology or histology which are recorded as invasive, but the lymph node status is unknown. The column is calculated as:
    
    The number of women where no LYMPH NODE STATUS has been recorded and where the BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known divided by total number of women with invasive cancer: Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Grade not known (% of invasive cancers) (column 58)

33. This column gives the percentage of cancers diagnosed by cytology or histology, which are recorded as invasive, but the cancer grade is not known. The column is calculated as:
    
    The number of women where the BIOPSY REFERRAL OUTCOME is Positive; i.e. cancer detected, invasive size not known, grade not known or Positive; i.e. cancer detected, invasive size known, grade not known divided by total number of women with invasive cancer: Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Special type not known (% of invasive cancers) (column 59)

34. This column gives the percentage of cancers diagnosed by cytology or histology which are recorded as invasive, but the special type is not known. The column is calculated as:
    
    The number of women where no INVASIVE CANCER SPECIAL TYPE INDICATOR has been recorded and where the BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known divided by Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Grade not known (% of DCIS) (column 60)

35. This column gives the percentage of cancers diagnosed by cytology or histology, which are recorded as ductal carcinoma in-situ (DCIS), but the grade is not known. The column is calculated as:
    
    The number of women where the BIOPSY REFERRAL OUTCOME is Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, grade not known (DCIS only detected) or Positive; i.e. cancer detected, definitely micro-invasive, grade not known (DCIS only detected) divided by total number of women with Non-invasive or possibly micro-invasive (column 27) plus Definitely microinvasive (column 28) multiplied by 100 (for the appropriate age group)

Part C1/6: Status of cancer

36. Part C1/6 gives status and grades of cancers detected.

Age Groups of women (first column) in Part C1/6.

37. The status of cancers are assessed within three groups: the first being those within the previous target age range of 50-64, the second within the current target age range of 50-70 and the third, the total of those reported, regardless of age.

Age Group (50-64) (line 43)

38. This is the outcome measure for women in the previous target age group 50-64

Age Group (50-70) (line 44)

39. This is the outcome measure for women in the current target age group 50-70

Total all ages (line 45)

40. This is the outcome measure for all women reported, regardless of age.

Women with an invasive cancer detected: number with lymph nodes sampled (column 61)

41. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION where a LYMPH NODE STATUS has been recorded.

Women with an invasive cancer detected: number positive (column 62)

42. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known where at least one REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS of lymph node positive has been recorded.
    
    Note where more than one REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS has been recorded for a woman and any one of the LYMPH NODE STATUSES is lymph node positive, then the woman should be included in column 62, but should not be included in column 63.

Women with an invasive cancer detected: number negative (column 63)

43. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS of lymph node negative.
    
    Note where more than one REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS has been recorded for a woman, then every LYMPH NODE STATUS should be lymph node negative for inclusion in count for column 63. If any of the LYMPH NODE STATUSES is lymph node positive, then the woman should be included in column 62 and not included in column 63.

Women with an invasive cancer detected: number with 4 or more nodes assessed (column 64)

44. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected invasive size not known with four or more REQUEST FOR PATHOLOGY INVESTIGATION where a LYMPH NODE STATUS has been recorded.

Women with an invasive cancer detected: number with 4 or more nodes sampled: number positive (column 65)

45. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with four or more REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS, any one of which is lymph node positive.

Women with an invasive cancer detected: number with 4 or more nodes sampled: number negative (column 66)

46. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with four or more REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS, any one of which is lymph node negative.

Women with an invasive cancer detected: number grade 1 (column 67)

47. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known, Grade I or Positive; i.e. cancer detected, invasive size not known, Grade I.

Women with an invasive cancer detected: number grade 2 (column 68)

48. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known, Grade II or Positive; i.e. cancer detected, invasive size not known, Grade II.

Women with an invasive cancer detected: number grade 3 (column 69)

49. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known, Grade III or Positive; i.e. cancer detected, invasive size not known, Grade III.

Women with an invasive cancer detected: number special type (column 70)

50. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION with a INVASIVE CANCER SPECIAL TYPE INDICATOR of special type.

Women with an invasive cancer detected: number not special type (column 71)

51. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION with a INVASIVE CANCER SPECIAL TYPE INDICATOR of not special type.

Women with DCIS only detected: number low or intermediate grade (column 72)

52. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, non-invasive or possibly micro-invasive low (DCIS only detected) or Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, intermediate (DCIS only detected) or Positive; i.e. cancer detected, definitely micro- invasive, low (DCIS only detected) or Positive; i.e. cancer detected, definitely microinvasive, intermediate (DCIS only detected).

    Women with DCIS only detected: number high grade (column 73)

53. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, high (DCIS only detected) or Positive; i.e. cancer detected, definitely micro-invasive, high (DCIS only detected).

KC62 TABLE C2

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Table C2: Routine invitation to previous attenders (Last screen more than 5 years)

This table reports the PERSON IN A SCREENING PROGRAMME for Breast Screening whose SCREENING STATUS is routine recall and the last SCREENING TEST was more than 5 years.


Part C2/1: Invitations and Outcomes

1. This is a summary of the outcomes of screening and assessment of all women invited and/or screened.

Age at first offered appointment (first column)

2. This is derived from the BIRTH DATE of the PERSON. Line 01 includes all women who were aged 44 or less at the time of the date of their first offered appointment for screening in the period covered by the return. Lines 02 to 06 include women in specified age groups. Line 10 includes all women who were aged 75 or over. Line 11 gives the total of all women in lines 03 to 08, giving a summary of the women in the NHS Breast Screening Programme target age range of 50 to 70 - the SCREENING POPULATION. Line 12 gives the total of all women in lines 01 to 10 regardless of age.

3. Lines 13 - 24 in Part C2/2 Assessment and lines 25 - 36 in Part C2/2 Cancers diagnosed follow the pattern described above.

Number of women invited (column 1)

4. Count of SCREENING TEST INVITATIONS where the first SCREENING TEST INVITATION has a TEST DATE OFFERED in the period covered by the return.

Lost to follow-up after technically inadequate screening mammogram (column 2)

5. Count of women whose SCREENING TEST RESULT classification was Inadequate test, and for whom no REFERRAL FOR BREAST ASSESSMENT was made.

Number screened (technically adequate) (column 3)

6. Count of women with a SCREENING TEST DATE in the period covered by the return whose SCREENING TEST RESULT classification was not Inadequate test.

Outcome of initial screen : Not known (column 4)

7. Count of women with a valid SCREENING TEST DATE but where no BREAST CANCER SCREENING TEST OUTCOME has been recorded.

Outcome of initial screen: Routine recall (column 5)

8. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Routine recall.

Outcome of initial screen: Early recall (column 6)

9. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Early recall but without a REFERRAL FOR BREAST ASSESSMENT.

Outcome of initial screen: Referred for assessment (column 7)

10. Count of women with a REFERRAL FOR BREAST ASSESSMENT. This covers all the women reported in columns 8 to 12.

Final outcome of assessment: Failed to attend for assessment (column 8)

11. Count of women with a REFERRAL FOR BREAST ASSESSMENT who failed to attend for all required assessment appointments and for whom there is no BREAST ASSESSMENT FINAL OUTCOME.

Final outcome of assessment: Outcome of assessment not known (column 9)

12. Count of women with a BREAST ASSESSMENT DATE but where no BREAST ASSESSMENT FINAL OUTCOME has been recorded.

Final outcome of assessment: Routine recall (column 10)

13. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Routine recall.

Final outcome of assessment: Early recall (column 11)

14. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Early recall.

Final outcome of assessment: Cancer (column 12)

15. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Cancer diagnosed. The total recorded in this column will equal the total recorded in columns 13, 18 and 24.

Part C2/2: Assessment

16. This part breaks down the outcomes of assessment by the procedures involved for all women assessed as a result of screening.

Cancer diagnosed without cytology or histology (column 13)

17. Count of women with a BREAST ASSESSMENT DATE whose BREAST ASSESSMENT FINAL OUTCOME classification was Cancer diagnosed, but who had no REFERRAL FOR BIOPSY or a REFERRAL FOR BIOPSY where the PATHOLOGY INVESTIGATION TYPE classification was not Cytology and the BIOPSY REFERRAL OUTCOME classification was Inconclusive.

Referred for cytology and/or core biopsy (column 14)

18. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment and a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy.

Not referred for open biopsy: No result recorded/inadequate result (column 15)

19. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment and a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women did not complete any or all procedures within 6 months of the date of the screen or had no BREAST ASSESSMENT FINAL OUTCOME recorded.

Not referred for open biopsy: Routine recall (column 16)

20. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Routine recall.

Not referred for open biopsy: Early recall (column 17)

21. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Early recall.

Not referred for open biopsy: Cancer (column 18)

22. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Cancer diagnosed.

Referred for open biopsy (column 19)

23. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy followed by a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy).

Total referred for open biopsy (column 20)

24. Total count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy).

Up to and including open biopsy: No result/inadequate result (column 21)

25. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BIOPSY REFERRAL OUTCOME classification of Inconclusive or Biopsy not done or result not yet known or did not attend for the biopsy within 6 months of the date of the SCREENING TEST having no recorded DATE BIOPSY TAKEN.

Up to and including open biopsy: Result: Benign/normal: Routine recall (column 22)

26. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). The BIOPSY REFERRAL OUTCOME classification is Benign or negative. The BREAST ASSESSMENT FINAL OUTCOME classification for these women is Routine recall.

Up to and including open biopsy: Result: Benign/normal: Early recall (column 23)

27. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). The BIOPSY REFERRAL OUTCOME classification is Benign or negative. The BREAST ASSESSMENT FINAL OUTCOME classification for these women is Early recall.

Up to and including open biopsy: Cancer (column 24)

28. Count of women with a REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). The BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer diagnosed. The BREAST ASSESSMENT FINAL OUTCOME classification for these women is Cancer diagnosed.

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Table C2: Routine invitation to previous attenders (Last screen more than 5 years)

Part C2/3: Cancers Diagnosed

1. This part of the return describes the cancers formally diagnosed in women assessed as a result of screening. Only breast cancers should be reported, as defined in the Information and Training Manual for England and Wales.

Age at first offered appointment (first column)

2. This is derived from the BIRTH DATE of the PERSON and the TEST DATE OFFERED of the first SCREENING TEST INVITATION within the period of the return.

Total number of women with cancer (column 25)

3. Count of all women in columns 18 and 24 of Part 2 Assessment i.e. those women with a proven diagnosis of breast cancer.

Invasive status not known (column 26)

4. Count of women included in Part 3 with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer diagnosed invasive status not known.

Non-invasive or possibly micro-invasive (column 27)

5. Count of women included in Part 3 with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer diagnosed non-invasive or possibly micro-invasive.

Definitely micro-invasive (column 28)

6. Count of women included in Part 3 with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer diagnosed definitely micro-invasive.

Invasive size (columns 29 - 33)

7. These columns count all cancers classified as invasive, separated according to the pathological size of the cancer (INVASIVE LESION SIZE). The BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer diagnosed invasive size known.

Invasive size (of cancer)	<10mm (column 29)
Invasive size (of cancer)	>=10mm & <15mm (column 30)
Invasive size (of cancer)	>=15mm & <20mm (column 31)
Invasive size (of cancer)	>=20mm & <50mm (column 32)
Invasive size (of cancer)	>=50mm (column 33)

Invasive size: Size not known (column 34)

8. This column counts invasive cancers where the BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer diagnosed invasive size not known.

Total invasive (column 35)

9. This column counts the total number of cancers classified as invasive, that is with a BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected invasive size known or Positive; i.e. cancer detected invasive size not known

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Table C2: Routine invitation to previous attenders (Last screen more than 5 years)

Part C2/4: Outcome measures

1. Part 4 presents a selection of outcome measures related to NHS Breast Screening Programme (NHSBSP) quality targets.
   

   Please note that where a column number is given within an outcome calculation, it relates to a specified column within the KC62 form for example:
   
   Number screened (technically adequate) (column 3) divided by Number of women invited (column 1) multiplied by 100 (for the appropriate age group).

   
   In this example (column 3) relates to Part 1 Invitations and Outcomes column 3.

Age Groups of women (first column)

2. Outcome measures are assessed within three groups: the first being those within the previous target age range of 50-64, the second within the current target age range of 50-70 and the third, the total of those reported, regardless of age.

Age Group (50-64) (line 37)

3. These are the outcome measures for women in the age group 50-64

Age Group (50-70) (line 38)

4. These are the outcome measures for women in the age group 50-70

Total all ages (line 39)

5. These are the outcome measures for women of all ages.

Uptake rate (% of invited) (column 36)

6. This column gives the uptake rate (also known as the acceptance rate) for screening. It is defined as the percentage of women who receive a technically adequate and complete screen as a result of an invitation for routine screening, and is calculated as:
   
   Number screened (technically adequate) (column 3) divided by Number of women invited (column 1) multiplied by 100 (for the appropriate age group).

Referral rate (% of screened) (column 37)

7. This column gives the rate of referrals to assessment from screening. It is defined as the percentage of women screened who are referred for any assessment procedure and is calculated as:
   
   Outcome of initial screen: Referred for assessment (column 7) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Non-invasive or micro-invasive cancers (per 1,000 screened) (column 38)

8. This column gives the cancers detected which are non-invasive, possibly micro-invasive, or definitely micro-invasive, per 1,000 screened calculated as:
   
   Non-invasive or possibly micro-invasive (column 27) plus Definitely micro-invasive (column 28) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Benign biopsy rate (per 1,000 screened) (column 39)

9. This column gives the women screened who have an open biopsy with a result of benign or normal per 1,000 screened, calculated as:
   
   Up to and including open biopsy: Result: benign/normal (columns 22 + 23) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Benign Therapeutic operation: Number (column 40)

10. This column gives the number of women screened who had a REFERRAL FOR BREAST TREATMENT and who had a BENIGN THERAPEUTIC OPERATION by the appropriate age group.

Benign Therapeutic operation: Rate (per 1,000 screened) (column 41)

11. This column gives the women screened who have a BENIGN THERAPEUTIC OPERATION per 1,000 screened, calculated as:
    
    Number of BENIGN THERAPEUTIC OPERATIONS for the period (column 40) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Invasive cancer detection rate (per 1,000 screened) (column 42)

12. This column gives the rate of invasive cancers detected per 1,000 women screened, calculated as:
    
    Total invasive (column 35) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Detection rate of invasive cancers <10 mm (per 1,000 screened) (column 43)

13. This column gives the rate of invasive cancers smaller than 10mm detected per 1,000 women screened, calculated as:
    
    Invasive size < 10mm (column 29) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Detection rate of invasive cancers <15 mm (per 1,000 screened) (column 44)

14. This column gives the rate of invasive cancers smaller than 15mm detected per 1,000 women screened, calculated as:
    
    Invasive size < 15mm (columns 29 + 30) divided by Number screened (technically adequate) (column 3) multiplied by 1000 (for the appropriate age group).

Referral rate for cytology and/or core biopsy (% of screened) (column 45)

15. This column gives the percentage of women screened who are referred for fine needle aspiration cytology and/or core biopsy as part of the assessment process, calculated as:
    
    Referred for cytology and/or core biopsy (column 14) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Referral rate for open biopsy (% of screened) (column 46)

16. This column gives the percentage of women screened who are referred for an open biopsy, either directly from screening or following other assessment procedures, calculated as:
    
    Total open biopsy (column 20) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Pre-operative diagnosis rate (% of cancers diagnosed) (column 47)

17. This column gives the percentage of cancers diagnosed cytologically or histologically without surgery, calculated as:
    
    Not referred for open biopsy Cancer (column 18) divided by (Not referred for open biopsy Cancer (column 18) plus Open biopsy: Cancer (column 24)) multiplied by 100 (for the appropriate age group).

Early recall rate following assessment (% of screened) (column 48)

18. This column gives the percentage of women screened who are recommended for early recall following any assessment procedure, calculated as:
    
    Early recall (column 11) divided by Number screened (technically adequate) (column 3) multiplied by 100 (for the appropriate age group).

Number of invasive cancers observed (column 49)

19. This column gives the total number of detected cancers classified as invasive, calculated as:
    
    Total invasive (column 35) (for the appropriate age group).

Number of invasive cancers expected (column 50)

20. This column is derived from the Number of invasive cancers observed (column 49) and a predefined incidence rate (calculated every three years for the appropriate age group).
    
    Please note KC62 is issued as an electronic spreadsheet and the predefined incident rate is contained within the spreadsheet for use within this calculation.

Standardised Detection Ratio (SDR) (column 51)

21. This column is derived from column 49 and column 50.
    
    Please note KC62 is issued as an electronic spreadsheet and the formula to calculate this ratio is contained within the spreadsheet.

Part C2/5: Data Completeness Indicators

22. Part C2/5 gives an indication of the completeness of data recorded on information systems in a variety of key areas.
    
    Please note that where a column number is given within an outcome calculation, it relates to a specified column within the KC62 form for example:
    
    Number screened (technically adequate) (column 3) divided by Number of women invited (column 1) multiplied by 100 (for the appropriate age group).
    
    In this example (column 3) relates to Part 1 Invitations and Outcomes column 3.

Age Groups of women (first column) in Part C2/5.

23. Data Completeness Indicators are assessed within three groups: the first being those within the previous target age range of 50-64, the second within the current target age range of 50-70 and the third, the total of those reported, regardless of age.

Age Group (50-64) (line 40)

24. These are the outcome measures for women in the previous target age group 50-64.

Age Group (50-70) (line 41)

25. These are the outcome measures for women in the current target age group 50-70.

Total all ages (line 42)

26. These are the outcome measures for all women reported, regardless of age.

Assessment result not known (% of referred) (column 52)

27. This column gives the percentage of women assessed for whom the final outcome of assessment is not recorded, calculated as:
    
    Outcome of assessment not known (column 9) divided by Referred for assessment (column 7) minus Failed to attend for assessment (column 8) multiplied by 100 (for the appropriate age group)

Cytology and/or core biopsy result not known (% of referred) (column 53)

28. This column gives the percentage of women referred for one or more cytology and/or core biopsy procedures, for whom a definitive result is not recorded and an open biopsy is not indicated. The column is calculated as:
    
    No result recorded/inadequate result (column 15) divided by Referred for cytology and/or core biopsy (column 14) multiplied by 100 (for the appropriate age group)

Open-biopsy result not known (% of referred) (column 54)

29. This column gives the percentage of women referred for an open biopsy for whom a definitive result is not recorded, calculated as:
    
    No result /inadequate result (column 21) divided by Total open biopsy (column 20) multiplied by 100 (for the appropriate age group)

Invasive status of cancer not known (% of all cancers diagnosed) (column 55)

30. This column gives the percentage of cancers diagnosed by cytology or histology in which the invasive status is not recorded. The column is calculated as:
    
    Invasive status not known (column 26) divided by Total number of women with cancer (column 25) multiplied by 100 (for the appropriate age group)

Size not known (% of invasive cancers) (column 56)

31. This column gives the percentage of cancers diagnosed by cytology or histology which are recorded as invasive, but have no size recorded. The column is calculated as:
    
    Size not known (column 34) divided by total number of women with invasive cancer Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Lymph node status not known (% of invasive cancers) (column 57)

32. This column gives the percentage of cancers diagnosed by cytology or histology which are recorded as invasive, but the lymph node status is unknown. The column is calculated as:
    
    The number of women where no LYMPH NODE STATUS has been recorded and where the BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known divided by total number of women with invasive cancer: Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Grade not known (% of invasive cancers) (column 58)

33. This column gives the percentage of cancers diagnosed by cytology or histology, which are recorded as invasive, but the cancer grade is not known. The column is calculated as:
    
    The number of women where the BIOPSY REFERRAL OUTCOME is Positive; i.e. cancer detected, invasive size not known, grade not known or Positive; i.e. cancer detected, invasive size known, grade not known divided by total number of women with invasive cancer: Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Special type not known (% of invasive cancers) (column 59)

34. This column gives the percentage of cancers diagnosed by cytology or histology which are recorded as invasive, but the special type is not known. The column is calculated as:
    
    The number of women where no INVASIVE CANCER SPECIAL TYPE INDICATOR has been recorded and where the BIOPSY REFERRAL OUTCOME classification is Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known divided by Total invasive (column 35) multiplied by 100 (for the appropriate age group)

Grade not known (% of DCIS) (column 60)

35. This column gives the percentage of cancers diagnosed by cytology or histology, which are recorded as ductal carcinoma in-situ (DCIS), but the grade is not known. The column is calculated as:
    
    The number of women where the BIOPSY REFERRAL OUTCOME is Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, grade not known (DCIS only detected) or Positive; i.e. cancer detected, definitely micro-invasive, grade not known (DCIS only detected) divided by total number of women with Non-invasive or possibly micro-invasive (column 27) plus Definitely micro-invasive (column 28) multiplied by 100 (for the appropriate age group)

Part C2/6: Status of cancer

36. Part C2/6 gives status and grades of cancers detected.

Age Groups of women (first column) in Part C2/6.

37. The status of cancers are assessed within three groups: the first being those within the previous target age range of 50-64, the second within the current target age range of 50-70 and the third, the total of those reported, regardless of age.

Age Group (50-64) (line 43)

38. This is the outcome measure for women in the previous target age group 50-64

Age Group (50-70) (line 44)

39. This is the outcome measure for women in the current target age group 50-70

Total all ages (line 45)

40. This is the outcome measure for all women reported, regardless of age.

Women with an invasive cancer detected: number with lymph nodes sampled (column 61)

41. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION where a LYMPH NODE STATUS has been recorded.

Women with an invasive cancer detected: number positive (column 62)

42. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known where at least one REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS of lymph node positive has been recorded.
    
    Note where more than one REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS has been recorded for a woman and any one of the LYMPH NODE STATUSES is lymph node positive, then the woman should be included in column 62, but should not be included in column 63.

Women with an invasive cancer detected: number negative (column 63)

43. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS of lymph node negative.
    
    Note where more than one REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS has been recorded for a woman, then every LYMPH NODE STATUS should be lymph node negative for inclusion in count for column 63. If any of the LYMPH NODE STATUSES is lymph node positive, then the woman should be included in column 62 and not included in column 63.

Women with an invasive cancer detected: number with 4 or more nodes assessed (column 64)

44. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected invasive size not known with four or more REQUEST FOR PATHOLOGY INVESTIGATION where a LYMPH NODE STATUS has been recorded.

Women with an invasive cancer detected: number with 4 or more nodes sampled: number positive (column 65)

45. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with four or more REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS, any one of which is lymph node positive.

Women with an invasive cancer detected: number with 4 or more nodes sampled: number negative (column 66)

46. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with four or more REQUEST FOR PATHOLOGY INVESTIGATION with a LYMPH NODE STATUS, any one of which is lymph node negative.

Women with an invasive cancer detected: number grade 1 (column 67)

47. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known ,Grade I or Positive; i.e. cancer detected, invasive size not known, Grade I.

Women with an invasive cancer detected: number grade 2 (column 68)

48. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known ,Grade II or Positive; i.e. cancer detected, invasive size not known, Grade II.

Women with an invasive cancer detected: number grade 3 (column 69)

49. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known, Grade III or Positive; i.e. cancer detected, invasive size not known, Grade III.

Women with an invasive cancer detected: number special type (column 70)

50. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION with a INVASIVE CANCER SPECIAL TYPE INDICATOR of special type.

Women with an invasive cancer detected: number not special type (column 71)

51. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, invasive size known or Positive; i.e. cancer detected, invasive size not known with a REQUEST FOR PATHOLOGY INVESTIGATION with a INVASIVE CANCER SPECIAL TYPE INDICATOR of not special type.

Women with DCIS only detected: number low or intermediate grade (column 72)

52. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, non-invasive or possibly micro-invasive low (DCIS only detected) or Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, intermediate (DCIS only detected) or Positive; i.e. cancer detected, definitely micro- invasive, low (DCIS only detected) or Positive; i.e. cancer detected, definitely microinvasive, intermediate (DCIS only detected).

    Women with DCIS only detected: number high grade (column 73)

53. Count of women with BIOPSY REFERRAL OUTCOME classification of Positive; i.e. cancer detected, non-invasive or possibly micro-invasive, high (DCIS only detected) or Positive; i.e. cancer detected, definitely micro-invasive, high (DCIS only detected).

KC62 TABLE D

Central Return Form Guidance

KC62: Adult Screening Programmes - Breast Screening

Table D: Early Recalls

This table reports the PERSON IN A SCREENING PROGRAMME for Breast Screening whose SCREENING TEST RESULT is Non-routine/early recall advised.


Part D1: Invitations and Outcomes

1. This is a summary of the outcomes of screening and assessment of all women invited and/or screened.

Age at first offered appointment (first column)

2. This is derived from the BIRTH DATE of the PERSON. Line 01 includes all women who were aged 44 or less at the time of the date of their first offered appointment for screening in the period covered by the return. Lines 02 to 09 include women in specified age groups. Line 10 includes all women who were aged 75 or over. Line 11 gives the total of all women in lines 03 to 08, giving a summary of the women in the NHS Breast Screening Programme target age range of 50 to 70 - the SCREENING POPULATION Line 12 gives the total of all women in lines 01 to 10 regardless of age.

3. Lines 13 - 24 in Part D2 Assessment and lines 25 - 36 in Part D2 Cancers diagnosed follow the pattern described above.

Number of women invited (column 1)

4. Count of SCREENING TEST INVITATIONS where the first TEST DATE OFFERED in the period covered by the return.

Lost to follow-up after technically inadequate screening mammogram (column 2)

5. Count of women whose SCREENING TEST RESULT classification was Inadequate test, and for whom no REFERRAL FOR BREAST ASSESSMENT was made.

Number screened (technically adequate) (column 3)

6. Count of women with a SCREENING TEST DATE in the period covered by the return whose SCREENING TEST RESULT classification was not Inadequate test.

Outcome of initial screen : Not known (column 4)

7. Count of women with a valid SCREENING TEST DATE but where no BREAST CANCER SCREENING TEST OUTCOME has been recorded.

Outcome of initial screen: Routine recall (column 5)

8. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Routine recall.

Outcome of initial screen: Early recall (column 6)

9. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Early recall but without a REFERRAL FOR BREAST ASSESSMENT.

Outcome of initial screen: Referred for assessment (column 7)

10. Count of women with a REFERRAL FOR BREAST ASSESSMENT. This covers all the women reported in columns 8 to 12.

Final outcome of assessment: Failed to attend for assessment (column 8)

11. Count of women with a REFERRAL FOR BREAST ASSESSMENT who failed to attend for all required assessment appointments and for whom there is no BREAST ASSESSMENT FINAL OUTCOME.

Final outcome of assessment: Outcome of assessment not known (column 9)

12. Count of women with a BREAST ASSESSMENT DATE but where no BREAST ASSESSMENT FINAL OUTCOMEhas been recorded.

Final outcome of assessment: Routine recall (column 10)

13. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Routine recall.

Final outcome of assessment: Early recall (column 11)

14. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Early recall.

Final outcome of assessment: Cancer (column 12)

15. Count of women with a BREAST ASSESSMENT DATE and a BREAST ASSESSMENT FINAL OUTCOME classification of Cancer diagnosed. The total recorded in this column will equal the total recorded in columns 13, 18 and 24.

Part D2: Assessment

16. This part breaks down the outcomes of assessment by the procedures involved for all women assessed as a result of screening.

Cancer diagnosed without cytology or histology (column 13)

17. Count of women with a BREAST ASSESSMENT DATE whose BREAST ASSESSMENT FINAL OUTCOME classification was Cancer diagnosed, but who had no BIOPSY REFERRAL OUTCOME or a REFERRAL FOR BIOPSY where the PATHOLOGY INVESTIGATION TYPE classification was not Cytology and the BIOPSY REFERRAL OUTCOME classification was Inconclusive.

Referred for cytology and/or core biopsy (column 14)

18. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment and a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy.

Not referred for open biopsy: No result recorded/inadequate result (column 15)

19. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment and a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women did not complete any or all procedures within 6 months of the date of the screen or had no BREAST ASSESSMENT FINAL OUTCOME recorded.

Not referred for open biopsy: Routine recall (column 16)

20. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Routine recall.

Not referred for open biopsy: Early recall (column 17)

21. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Early recall.

Not referred for open biopsy: Cancer (column 18)

22. Count of women with a BREAST CANCER SCREENING TEST OUTCOME classification of Referred for assessment, a subsequent REFERRAL FOR BIOPSY with a PATHOLOGY INVESTIGATION TYPE classification of Cytology or Core biopsy but without any PATHOLOGY INVESTIGATION TYPE classification of Histology (open biopsy). These women have a BREAST ASSESSMENT FINAL OUTCOME classification of Cancer diagnosed.