Causes of breast cancer misdiagnosis at physical examination.
2740 consecutive breast cancers undergoing physical examination were reviewed. Ninety-two subclinical cancers detected at mammography were excluded from further evaluation and the study focused on palpable false benign cancers. The sensitivity of physical examination varied according to T category (TIS = 0.48, T1 = 0.70, T2 = 0.90, T3 = 0.89, T4 = 0.93), age (20-29 = 0.77, 30-39 = 0.58, 40-49 = 0.75, 50-59 = 0.84, 60-69 = 0.90, greater than 69 = 0.94) and operator (range 0.69-0.89), a significant difference being recorded in favor of more expert operators. Multivariate analysis (Cox) showed that T category, patient's age and operator experience are independent determinants of sensitivity. This study confirms that physical examination is not very sensitive, particularly for small tumors and in younger women and should always be performed by expert operators.
Ciatto
S
S
Center for Investigation and Cancer Prevention, Firenze, Italy.
Rosselli del Turco
M
M
Catarzi
S
S
Cataliotti
L
L
Cardona
G
G
Teglia
C
C
Pacini
P
P
Caridi
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis*; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D015999:Multivariate Analysis; D010808:Physical Examination; D012680:Sensitivity and Specificity