Simple form can improve accuracy of breast exams

March 31, 2010 7:29:40 PM PDT
Bay Area researchers are suggesting a low-tech method to improve the odds of detecting breast cancer. Its target is a common breast exam and the way doctors perform it.

While mammograms detect thousands of cases of breast cancer every year, physical breast exams can catch the cancers that the scans can miss. Now, a new study is suggesting a way to increase the accuracy of breast exams, not with increased technology, but increased concentration.

"What we're talking about is the quality of the examination and what we're saying is if the doctor actually stops and focuses on what's going on, the doctor will do a better examination," says William Goodson, MD, from the California Pacific Medical Center Research Institute.

In a randomized trial, Goodson's team asked doctors to fill out one of two forms during a breast exam. A longer form required physicians to list specific descriptions of the breast, along with details from the breast examination. The second, shorter form required only the clinical details from the exam. They then compared the number of abnormalities found by both groups, to averages from previous years.

"If you looked at call rate and the year before we started the study was about 3.5 percent and the call rate in the year that we did the study, was just short of 8 percent. So we just about doubled what was going on with patients," says Goodson.

In other words, the doctors using the forms spotted abnormalities more than twice as often.

The extra paperwork itself might seem like an added burden on a busy clinical practice, but a second finding from the same study suggests that might not actually be the case.

Remember the doctors who were given either the long or short forms? When researchers compared those groups against each other, they found it did not matter which form was used, both groups had the improved results.

"Asking the doctor to pay attention, to focus on doing a breast exam, really made a difference," says William Goodson.

He says the improvement is significant, since nearly 17 percent of early breast cancers are not detected by mammograms, but can be spotted by a physical exam.

Goodson does not expect the findings to lead to any immediate change in guidelines for breast exams, but the results will be published this month in the American Journal of Medicine.

Written and produced by Tim Didion


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