Measuring performance in clinical breast examination

Wishart, Gordon; Warwick, Jane; Pitsinis, Vassilis; Duffy, Stephen W.; Britton, P

doi:10.1002/bjs.7108

Cited by 12 publications

(11 citation statements)

References 11 publications

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“…The present study agreed that clinical breast examination alone was not adequate for cancer diagnosis [8, 19]. Although FNAC on top of baseline information might be efficient (AuROC = 92.47%, OR = 3.52, P < 0.001) [7, 20–23], but false-negative results from FNAC may lead to delayed and/or under treatment, while false-positive results may lead to over treatment [24].…”

Section: Discussionsupporting

confidence: 72%

Are Both Ultrasonography and Mammography Necessary for Cancer Investigation of Breast Lumps in Resource-Limited Countries?

et al. 2013

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Objective. To reevaluate the diagnostic value of breast imaging in the diagnosis of breast cancer in areas where health resources are limited. Methods. Patients were women presenting with breast lumps in two university-affiliated tertiary hospitals, Thailand, during 2006 and 2010. Clinical data were abstracted from the breast cancer registration database and patient records. The diagnostic predictive ability of ultrasonography and mammography was obtained from logistic regression analysis and presented with areas under the receiver operating characteristics (AuROCs) curves. Results. Among 3129 breast lumps (3069 women), 854 were diagnosed with breast cancer by certified pathologists. Age and size of lumps alone already predicted cancer correctly in 77.45% (AuROC = 77.45). Additional ultrasonography increased the prediction to 96.22% (P < 0.001). Additional mammography also increased the prediction to 95.99% (P < 0.001). Performing both imaging modalities did not increase the prediction clinically (0.01%–0.24%). More accurate prediction (2.07%–2.21%) may be added by fine needle aspiration cytology (FNAC). Conclusions. Breast imaging is still valuable in settings where health resources are limited. Single breast imaging (only either ultrasonography or mammography) is adequate for cancer diagnosis. It is therefore unnecessary to perform both imaging modalities. Accuracy of the diagnosis may be improved by FNAC, if available.

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Section: Discussionsupporting

confidence: 72%

Are Both Ultrasonography and Mammography Necessary for Cancer Investigation of Breast Lumps in Resource-Limited Countries?

et al. 2013

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“…The CE component of the triple assessment appears to have the least sensitivity in the diagnosis of carcinoma and the sensitivity decreases with deceasing age, presumably owing to more glandular rather than fatty breasts in younger women. 8 On the other hand, over the years, advances in ultrasonography have improved the quality of imaging significantly, and sonography can now be used to accurately classify solid breast lesions as benign with a negative predictive value of 99.5% and a sensitivity of 98%. 9 There are now also dedicated breast radiologists in most breast units in the UK and elsewhere who perform a large number of breast ultrasonography scans, which should improve its accuracy.…”

Section: Discussionmentioning

confidence: 99%

Triple assessment is not necessary in most young women referred with breast symptoms

Yue

Swinson

Ravichandran

2015

annals

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INTRODUCTION A palpable lesion in the breast is usually subjected to triple assessment (clinical examination [CE], imaging and core biopsy [CB] or fine needle aspiration [FNA]) to minimise the risk of missing breast cancer. However, breast cancer is rare in young women, and triple assessment (especially CB) is invasive and expensive. Our aim was to see whether CB/FNA could be avoided in young women with benign findings on CE and imaging. METHODS This study analysed data from a prospectively entered database on female patients aged under 25 years who attended a rapid diagnosis breast clinic over a 68-month period. RESULTS Among 10,301 patients seen, 955 females (9.3%) were aged <25 years. The most common presenting complaint was a lump, followed by pain and nipple discharge. CE was normal or revealed benign findings in all except 15 patients, in whom it was indeterminate. Ultrasonography was performed in 692 patients (72%) and was normal (n=289) or benign (n=382) in all except 21 patients, in whom it was indeterminate. In six patients, both were indeterminate. A total of 317 patients (35%) had triple assessment: FNA in 106, CB in 239 and both in 9 cases. No cancers were diagnosed. CONCLUSIONS It would appear safe to omit FNA/CB in patients aged under 25 years when clinical and ultrasonography findings are normal or benign. This approach would have avoided needle biopsies in all but 30 patients (3%) in the study.

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“…Breast self-examination is an inexpensive, cost-effective and easy screening method, which can be used for diagnosis of 95% of malignant breast tumors by monthly self-examination. [6][7][8] The US Cancer Institute recommended that breast selfexamination should be initiated from age 20 years to improve the health condition and early diagnosis of breast cancer among women. 9 Self-examination is not at all a diagnostic method, at the moment; it's simply used as a contribution to screening.…”

Section: Introductionmentioning

confidence: 99%

Breast self-examination: assessing its knowledge attitude and practice among ethnic Kashmiri females

Sideeq¹,

Ayoub²,

Khan³

2017

Int J Community Med Public Health

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INTRODUCTIONCancer of breast is disease which affects many dimensions of health as it gives physical, emotional, psychological as well as economical set back to the women affected. Among women breast cancer is the most common cancer diagnosed globally (25.2 % of all new cases of cancers).1 A recent report by the Indian Council of Medical Research predict the number of breast cancer cases in India to rise to 106,124 in 2015 and to 123,634 in 2020. 2 Breast cancer is now the most common cancer among women in India and accounts for 7% of global burden of breast cancer.3 Among Kashmiri women breast cancer is the second leading cancer after esophageal cancer, with an incidence rate of 12.6 per 100,000. 4 The incidence, mortality and survival rates for breast cancer vary across the globe because of underlying differences in known risk factors, availability of organized screening programs and access to effective and affordable treatment modalities. Studies have shown that in contrast to the developed nations most of the developing nations have recorded a poor outcome and high fatality rate owing to diagnosis of the breast cancer in advanced stages. Globally, breast self-examination (BSE), clinical breast examination (CBE) and mammography are the recommended screening test for early detection of breast cancer. 5 Due to lack of access to diagnostic facilities, especially for women in low resource settings, it is essential to empower them with BSE as a primary modality for screening. Breast self-examination is an ABSTRACT Background: Breast cancer is the most common cancer among women worldwide but is the second commonest cancer in Kashmir women. The most easy and cost effective way of early detection of breast cancer is through breast self-examination (BSE) the utility of which can help to make early interventions and thus better prognosis. The objectives of the study were to assess the knowledge and practice about breast self-examination among ethnic Kashmiri females. Methods: A cross sectional descriptive study was done among ethnic Kashmiri women. A sample 250 women in the age group of 20 to 60 years was selected from SMHS hospital. A predesigned semi-structured study instrument was used to collect the data through interview method. Results:The results showed that only 26% of the participants had ever heard of breast cancer and among them for 50.8% the source of information was media. Regarding knowledge of breast self-examination 92.4 % had never heard of it. Only 5.6% participants had self-examined their breast. Conclusions:The study points to the insufficient knowledge of Kashmiri females about breast cancer and its simplest screening method of self-examination.

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Measuring performance in clinical breast examination

Abstract: The performance measures outlined here could help to identify clinicians who have a lower sensitivity for CBE and who may therefore require feedback and further training.

Cited by 12 publications

References 11 publications

Are Both Ultrasonography and Mammography Necessary for Cancer Investigation of Breast Lumps in Resource-Limited Countries?

Are Both Ultrasonography and Mammography Necessary for Cancer Investigation of Breast Lumps in Resource-Limited Countries?

Triple assessment is not necessary in most young women referred with breast symptoms

Breast self-examination: assessing its knowledge attitude and practice among ethnic Kashmiri females

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