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

Risa B. Burns, MD, MPH; Karen M. Freund, MD, MPH; Arlene S. Ash, PhD; Michael Shwartz, PhD; Lisa Antab, MPH; Ruth Hall, MSc
Arch Intern Med. 1996;156(7):741-744. doi:10.1001/archinte.1996.00440070061007.
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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)


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