April 8, 1996

As Mammography Use Increases, Are Some Providers Omitting Clinical Breast Examination?

Author Affiliations

From the Evans Department of Medicine, Boston University Medical Center Hospital (Drs Burns, Freund, and Ash and Mss Antab and Hall); and Boston University School of Management (Dr Shwartz), Boston, Mass.

Arch Intern Med. 1996;156(7):741-744. doi:10.1001/archinte.1996.00440070061007

Objective:  To explore use of clinical breast examination (CBE) among women receiving mammography.

Methods:  A retrospective cohort analysis of 100 women aged 50 years or older with at least one bilateral mammogram. Chart review documented demographic information, severity of illness, and performance of CBE (from 1 year prior to 18 months after the mammogram).

Results:  The mean age of the 100 women was 63 years. They were predominantly unmarried (60%), nonwhite (58%), and not currently employed (57%). Three quarters (76%) had mammography and CBE (comprehensive screening), while the remaining 24% had mammography only. Sociodemographic factors did not differ for women with and without comprehensive screening (P>.1). However, patients of female providers were more likely to receive comprehensive screening than patients of male providers. Specifically, 95% of women seen by female attending physicians or fellows had comprehensive screening vs 67% for male attending physicians or fellows and 61% for residents (P=.008).

Conclusions:  Mammography may be replacing CBE especially among patients of male providers. Interventions targeted to these providers could help improve the use of CBE and mammography.(Arch Intern Med. 1996;156:741-744)