Breast cancer screening. Changing physician practices and specialty variation

Baseline surveys of primary care physicians and women on Long Island were conducted to determine breast cancer screening practices prior to introducing educational interventions to increase the use of mammography and breast examination in women aged 50 and older. Eighty-seven percent of the physicians (323) and 74% of the women (1,440) responded to postal surveys. Forty-eight percent of the physicians reported ordering regular screening mammograms on all asymptomatic female patients in this age group, with a significantly higher percentage reported by obstetrician/gynecologists than by family practitioners or internists. Only 24% of the women reported having had a mammogram within the past year. Lack of physician recommmendation was the reason most frequently cited by women for not having had a mammogram. Findings point to the need for continuing medical education about consensus breast cancer screening guidelines, particularly the importance of combining both physical examination and mammography, and the need for patient education to minimize patient concerns.