The Journal of the American Medical Association has published a new study which points to the value of having more structure in the breast exam process for M.D.s—not more time for more elaborate exams.

The additional structure was added with the use of a dedicated evaluation form for patients’ breast exams. It did not matter if the form was short or detailed, the study says.

The study showed an increase of referrals for more advanced breast evaluation.  This increase went from  from 4.7% to 8.3% in the study year.

Please note—in the continuing series of studies with conflicting results on mammogram’s effectiveness—that physicians are the first to identify one in 10 breast cancers. Approximately one-third of those cancers read negative on a mammogram, this Medpage Today story says.

Women should pay special attention when their regular doctors perform breast exams. These are one way to find cancers mammograms may miss. Don’t skip this step.

Medpage Today

“Referrals for follow-up advanced breast examinations almost doubled after clinicians at a community health center started using a dedicated evaluation form following routine breast exams as part of a year-long study, researchers reported. (Emphasis added)

“The proportion of breast examinations leading to referral increased from 4.7% in the year before the study to 8.3% during the study period, according to an article in the April 1 American Journal of Medicine. The increase was similar whether clinicians used a brief form or one with more detail. (Emphasis added)

“The improvement in referrals, known as the call rate, occurred without retraining the practitioners in breast evaluation, researchers said. (Emphasis added)

“In larger series, clinicians are the first to identify one in 10 breast cancers, approximately one-third of which have negative mammograms,” William H. Goodson III, MD, of California Pacific Medical Center Research Institute in San Francisco, and colleagues noted in their report. (Emphasis added)

“It would be difficult to abandon these opportunities to detect breast cancer and thus difficult to abandon breast examination. We believe a more effective approach is to retain clinical breast examination but to develop tools to focus clinician attention rather than to demand more clinician time for a more elaborate technique.” (Emphasis added)

Source: Medpage Today, March 31, 2010

Citation:Am J Med 2010; DOI:10.1016/j.amjmed.2009.08.023.