Evaluation and outcomes of women with a breast lump and a normal mammogram result
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BACKGROUND: Many women experience a breast lump. Clinical guidelines suggest that a normal mammogram result alone is not adequate to exclude a diagnosis of cancer.
OBJECTIVE: To examine the characteristics of women with a breast lump and a normal mammogram that were associated with receiving further evaluation, and to examine cancer outcomes.
DESIGN: Observational cohort.
PARTICIPANTS: Women aged 35 to 70 years who participated in a population-based mammography registry and who did not have a history of breast cancer noted at the time of their mammogram that they had a breast lump, and had a “normal” (Breast Imaging Reporting and Data System 1 or 2) mammogram result (n=771).
MEASUREMENTS: Telephone survey performed 6 months after the mammogram to ascertain information about evaluation. Cancer outcomes within 12 months of the index mammogram were confirmed through linkage with a cancer registry.
RESULTS: Only 56.9% of women reported receiving an adequate evaluation for their breast lump, including a subsequent clinical breast exam, a visit to a breast specialist, an ultrasound, a biopsy, or aspiration. Latinas were less likely than white women to have received adequate evaluation, as were obese women compared with normal-weight women, and uninsured women compared with women with insurance. Among women with at least 12 months of follow-up, 1.4% were diagnosed with cancer.
CONCLUSIONS: Many women do not receive adequate evaluation for a recent breast lump. Interventions should be designed to improve the follow-up of women with this common clinical problem.
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- Evaluation and outcomes of women with a breast lump and a normal mammogram result
Journal of General Internal Medicine
Volume 20, Issue 8 , pp 692-696
- Cover Date
- Print ISSN
- Online ISSN
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- breast cancer
- mammogram quality
- Industry Sectors
- Author Affiliations
- 1. Department of Medicine, Division of General Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Mass, USA
- 2. Harvard Medical School, Harvard, Mass, USA
- 3. Department of Medicine, Medical Effectiveness Research Center, Division of General Internal Medicine, University of California, San Francisco, Calif, USA
- 4. Department of Veterans Affairs, Departments of Epidemiology and Biostatistics, and Medicine, General Internal Medicine Section, University of California, San Francisco, Calif, USA