Family physicians expedite diagnosis of breast disease in urban minority women.

BACKGROUND

The specialty of a patient's usual provider of care is associated with use of mammography and stage of breast cancer diagnosis. It is unknown if specialty of usual provider of care affects time from discovery of a breast screening abnormality to diagnostic resolution.

METHODS

Retrospective chart review study of 546 women who had breast biopsies at an urban public university hospital from 2001 to 2005. Time from abnormal mammogram or clinical breast examination to pathology report was compared by specialty of usual provider of care, sociodemographic, and clinical factors. Multivariate logistic regression was conducted to assess predictors of having diagnostic interval greater than 60 days.

RESULTS

The median diagnostic interval was 36 days (interquartile range 21 to 63). After controlling for age, race, insurance, specialty of usual provider of care, employment status, and palpable lump, decreased odds of having diagnostic delay (over 60 days) included having a family physician (odds ratio (OR) 0.242; 95% confidence interval (CI), 0.09 to 0.69), private health insurance (OR 0.360; 95% CI, 0.15 to 0.89), and cancer diagnosis (OR 0.324; 95% CI, 0.17 to 0.61).

CONCLUSIONS

To improve timely follow-up of minority urban women with breast abnormalities, promoting development of a relationship with a family physician may be an important public health intervention.