Specialist nurses have an established role in the management of breast cancer in helping patients to understand their disease and treatment options, and in offering counselling and emotional support 1 2; they are not usually involved in diagnosis.

In 1987 two clinical nurse specialists were appointed to the breast care clinic at our hospital; they were given responsibility for running outpatient clinics for symptomatic patients, including new referrals. The nurses take histories, examine the women, request imaging, and perform fine needle aspirations when appropriate. Test results are given by the nurses to both the patients and their general practitioners. The specialist surgeon sees patients who have been newly diagnosed with cancer and any patients for whom the evidence is equivocal. This paper describes patient satisfaction with a nurse led clinic screening for breast diseases in London and assesses the clinical expertise of the nurses.