Researchers advocate improved breast cancer screening techniques

Review of clinical data indicates need for standardized examination to improve physicians' precision and accuracy

BOSTON, MA - September 30, 1999 - Standardized examination techniques are needed to improve physicians' accuracy in screening for breast cancer, according to a review article in the October 6, 1999 edition of the Journal of the American Medical Association. Despite the general acceptance and practice of screening for breast cancer, available data indicates that establishing uniform techniques would likely increase early detection of the disease, according to researchers at Harvard Pilgrim Health Care and Harvard Medical School.

Breast cancer is the second leading cause of cancer deaths in women, and is the leading cause of cancer deaths among women aged 40 to 55. Experts agree that a combination of early detection and timely treatment can and does save women's lives. A standardized clinical breast examination (CBE) would likely increase early detection by improving examiners' sensitivity to lumps in the breast. Failure to diagnose breast cancer is a leading reason for malpractice claims, and clinicians who do not perform careful screening may be at increased risk of medical liability.

The review's findings indicate that spending adequate time on the CBE and using the proper techniques improves breast lump detection, although the authors point out that summarizing the precision and accuracy of the CBE is difficult. Even when performed in large-scale studies, the examination technique generally has not been standardized. The available studies included women differing in age, history of symptoms, and practice settings. Furthermore, the reported test characteristics of the CBE in the available studies were determined sometimes with and sometimes without accompanying mammography screening. Studies utilizing silicone models of the breast uniformly demon

Contact: Bill Schaller
Harvard Medical School

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