Method of discovery of breast cancer.

PURPOSE: The purpose of this study was to determine how breast cancers are found according to the frequency of breast self-examination, mammography, and clinical examinations. Additionally, the means of discovery according to age, race, family history, and educational level was determined.

DESCRIPTION OF STUDY: The study was a retrospective, descriptive design using a nonprobability sample of 51 women diagnosed with breast cancer during 1991-1992. Anonymous questionnaires were used for data collection.

RESULTS

Overall, the most frequent method of discovery was mammogram (n = 20; 39%), followed by breast self-examination (n = 18; 35%), accidental palpation by self (n = 7; 14%), clinical examination (n = 3; 5.9%), and by accidental palpation by another person such as husband/lover (n = 3; 5.9%). Only 10 of the 51 women 40 years of age and older followed all American Cancer Society guidelines for breast cancer detection. Of these, 60% of the cancers were found by breast self-examination. Similarly, breast self-examination was the most frequent method for white women, and for women with a high school education or higher. Mammography was the most frequent means for black women, for women with less than a high school education, and for women with a negative family history of breast cancer. Of particular concern was the fact that of the 20 women having mammograms every 1 to 2 years before diagnosis, half (n = 10) had breast cancer found by palpable means.

CLINICAL IMPLICATIONS: All three breast cancer detection methods--breast self-examination, mammography, and clinical breast examinations--should be emphasized by health professionals given that mammography alone is not 100% accurate.